Total Hip Replacement For Treatment Of Hip Diseases

Total hip replacement(THR) is one of the greatest surgicalinventions since the20th century. It can improve and enhance the lifequality of hip diseases, the work ability. British orthopedic doctor JohnCharnley pioneered the theory of artificial joint replacement andlow-friction hip arthroplasty. Total hip replacement (THR) started a newchapter. Dr. Charnley designed stainless steel femoral prosthesis,polyethylene materials and cement fixation (polymethyl methacrylate),which laid the foundation for the low-friction replacement technology.Charnley’s artificial joint is still by far the gold standard to hip jointreplacement surgery. In the21st century, with medical technology,medical biomaterials technology innovation,surgical techniquesimprovement and the medical engineering enhancing,total hipreplacement is gradually tend to be precise and minimally invasivesurgery,and success rate significantly improved. Total hip replacement isstill the most common reconstructive surgery,and is one of the mostsuccessful surgical interventions.In recent years People have done manyresearches for the scientific investigation,the evaluation of clinical resultsand the treatment to complications.Now research center focus on deepvein thrombosis(DVT), medical-legal events and surgery-industrialtechnology in many aspects.Current progress in THR is concentrated in the following areas: primary THR efficacy;revision THR and the newtechnologies in enhancement of bone growth and fixing;total hipresurfacing; minimally invasive surgery;study in complications.In thispaper,we summarize the current indications of THR, the THR curativeeffect, and development prospects. We have199THR cases from2009to2013to follow up,and the successful follow-up cases are141cases.Thesuccessful follow-up patients are divided into three groups according todifferent diseases, A (osteonecrosis of femoral head), B (femoral neckfracture), C (DDH).We took hip anterioposterior dimension pictures,andwe graded the patients with harris scores after routine physicalexamination.We view the score as a reference standard,and analysis THRcurative effect on patients with different hip diseases.We read relevantliterature,and analyze the pathogenesis and guide the THR treatment.Objective:To compare the THR curative effect to different hip diseases, andguide the THR treatment.Materials and Methods:141THR cases treated in the same medical group from2009to2013were followed up.The patients are divided into three groups according todifferent diseases, A (osteonecrosis of femoral head), B (femoral neckfracture), C (DDH).Male cases in A are31patients (43hips), femalecases are28cases (37hips),total59cases(80hips), with an average age of51.4years old,without trauma history,multiple cases’complaints aredrinking history,the steroid use history.The hip anterioposteriordimension pictures show lesions were to Ficat Ⅲ, Ⅳ stage; Male casesin B are22cases (27hips), female cases are41cases (60hips),total63cases(87hips), with an average age of62.5years old; Male cases in Care2cases (2hips)and female patients are17cases (27hips), total19cases(29hips),classifation by Crowe type: CroweⅠ7cases, CroweⅡ4cases, Crowe Ⅲ5cases,CroweⅣ13cases. These patients maincomplaints are hip pain and the limited mobility.We took the preoperativeand postoperative hip anterioposterior dimension pictures and took thepatients’ shoot.We graded Harris scores after routine physicalexamination,using SPSS software to analyse data.As a reference,weanalysed THR curative effect to different hip diseases by reading relevantliterature, and analyze the pathogenesis and guide the THR treatment.Results:Group A preoperative Harris score is38±11.7, postoperativescore is88±9.7, Harris score improved by50±10.8, good rate is95.4%. Group B preoperative Harris score is28±11.7, postoperativescore is81±7.6, Harris score improved by53±11.1, good rate is85.2%.Group C Harris preoperative Harris score is49±11.0,postoperative score is82±9.2, Harris score improved by33.1±13.0,good rate is72.4%. P <0.05 Conclusions:By comparing the Harris score, we can summarize the THRtreatment to femoral neck fracture improved the most, followed byosteonecrosis of the femoral head, DDH minimal improvement. TheTHR treatment to osteonecrosis of the femoral head is the highest goodrate, followed by femoral neck fracture, DDH’s good rate is minimum.