Hormone Drugs Avascular Necrosis Of Femoral Head Of Total Hip Replacement Prosthesis Loosening After Analysis

Objective: Long-term use of corticosteroids or anti-inflammatory drugs (Yan Xikang pain, inflammatory pain, etc.) may result in avascular necrosis of femoral head, which Xikang inflammatory drugs such as pain caused by avascular necrosis of femoral head have been relatively rare, and long-term use glucocorticoid-induced avascular necrosis of the cases has increased year by year. Avascular necrosis of the following four common causes:â‘ Traumatic avascular necrosis of femoral head, is commonly found in the femoral neck fracture and dislocation of the hip and so on.â‘¡Drug steroid-induced femoral head avascular necrosis, is commonly found in long- term use of corticosteroid corticosteroids can indirectly damage the blood supply of the femoral head, femoral bone lead to further ischemia, degeneration and necrosis. In non-traumatic avascular necrosis of femoral head, the hormone caused by drugs accounted for the first and higher trend has aroused extensive attention.â‘¢Alcoholic avascular necrosis of femoral head, is commonly found in large quantities of alcohol.â‘£Decompression sickness, decompression sickness is due to the environment where the pressure drop caused by the syndrome, avascular necrosis of femoral head for one of the symptoms of decompression sickness.Avascular necrosis as a result of the etiology, pathogenesis has not yet been clearly brought to the clinical treatment more difficult. Although the treatment of this disease in various ways, such as traditional Chinese medicine therapy, intervene- tional therapy, hyperbaric oxygen therapy and other non-surgical treatment and Core decompression, not blood transp- lantation of bone transport, vascularized bone grafting, vascularized pedic- led bone grafting and total hip arthroplasty and other surgical treatment, but so far there is no one way to achieve satisfactory clinical results. Especially in the late avascular necrosis of femoral head of patients, the vast majority of orthopedic surgeons believe that total hip arthroplasty is the late avascular necrosis of femoral head in patients with the best treatment. Although total hip arthroplasty for avascular necrosis of femoral head in patients with advanced can ease pain, hip reconstruction, but there are also many short-term and long-term complications. Such as postoperative infection, dislocation of prosthesis, deep vein thrombosis, femoral or acetabular fracture and aseptic loosening of prosthesis such as aseptic loosening of prosthesis which is considered the impact of efficacy of the most common and the most important long-term One of the complications of drug and hormone factors traumatic avascular necrosis of femoral head in patients with advanced, the total hip arthroplasty loosening of the prosthesis after comparison revealed that the former is the incidence of prosthesis loosening than after. The patients on the drug and steroid- traumatic avascular necrosis of femoral head of total hip arthroplasty loosening of prosthesis for analysis.Methods: May 1999 - May 2005 months to the diagnosis and treatment in our hospital, aged between 31-65 years of age, diagnosed as drug steroid- induced femoral head avascular necrosis, after non-surgical treatment does not work, the basis of clinical symptoms and imaging school performance, has been the development of avascular necrosis of femoral head late in patients with hip pain, activity limitation obviously, a serious collapse of the femoral head, dislocation or secondary osteoarthritis, and not suitable to do the surgery to retain the femoral head, the line total hip arthroplasty in 21 patients (23 hips), admitted to the same time, diagnosed as traumatic avascular necrosis of femoral head, with a total hip arth- roplasty in patients with indications of the 19 cases (19 hips) had surgery As a control, from improving the situation after the original symptoms, complications, long-term clinical and radiographic results were evaluated. Mainly through out-patient review, such as telephone follow-up study conducted. The mean follow-up 96.1 months (48-120months).Results: (1) All patients with follow-up to 8 years, the overall rate of 88.5 percent fine. The overall mean follow-up of 96.1 months, 27 of them excellent hips, good in 7 hips, 6 hips and poor in 2 hips, the overall rate of 81.0% excellent. Hormone excellent group of 12 hips, good in 4 hip, hip, 4, 3 bad hip, good rate of 69.6%; control group, 10 hips excellent, 6 good hip, 2 hip, hip a poor, good rate of 84.2%. Rate between the two groups of good statistical analysis of significance of the difference was significant (X2 test, P: 0.012 <0.05). (2) loosening of prosthesis and renovation:â‘ 4 overall loosening of hip, loosening rate was 9.5%. Hormone group and control group 3 were loose and 1 hip hip, loosening rates were 13.0% and 5.3%; hormone group than the rate of prosthesis loosening the high rate of loosening of the control group, statistical analysis of significance of the difference was significant (P: 0.017 <0.05, X2 Test). Group 3 hip hormone renovation, the renovation of the rate of 13.0%, renovation of the control group and no case.Conclusion: (1) steroid-induced avascular necrosis of femoral head of artificial total hip arthroplasty than artificial prosthesis loosening traumatic avascular necrosis of femoral head of total hip arthroplasty high. (2) hormones can cause proximal femoral osteoporosis, resulting in the rela- tively poor condition of parts of bone; femoral calcar mechanics can not play a good supporting role, resulting in the sinking prosthesis, loosening occurred.