The Analysis And Treatment Of 34 Cases Revision Total Hip Replacement

0bjective Analyze the reasons and probe the surgical treatment for revision after primary total hip replacement.Methods From March of 2003 to January of 2010,there were 34 cases revision total hip replacement in the First Affiliated Hospital of Fujian Medical University,by the patients' medical history, preoperative and postoperative imaging examination, inspection reports, and intraoperative findings, postoperative pathology and microbiology report in connection with reported in the literature, analyze and probe the reasons and surgical treatment for revision total hip replacement.Resultsâ‘ Among the 34 cases revision total hip replacement,the most common and accounts for the first cause was: aseptic loosening of prosthesis ,the rest followed by was recurrent dislocation or dislocation can not be reset,infection after joint replacement,periprosthetic fractures,prosthesis fracture.â‘¡Periprosthetic bone defects treatment: 8 hips of acetabulum Gustilo I type and II type loosening, using close-type cementless press-fit prosthesis or bone cement prosthesis, whether to graft was under the conditions of acetabular floor defect,3 hips of III type acetabular loosening , using massive bone and close pressure with implants. 1 hips of IV type loosening, using allograft bone with anatomic reconstruction and bone cement acetabular component molding. 3 hips of femoral Gustilo I prosthesis loosening, After the prosthesis being removed, implanting titanium plus normal shank or long-handled depending on the situation of bone conditions. 7 and 8 hips of Gustilo II and III loosening,implant long-handled after removing the prosthesis, carrying periprosthetic Bone graft depending on the degree of bone defects and osteoporosis, bundled with a fixed when necessary. 2 cases of Gustilo IV type loosening, carrying bone graft reconstruction and bundled with fixed.Conclusionâ‘ Prosthesis aseptic loosening is the main cause that induced the revision total hip replacement. Prosthesis loosening is concerned with prosthesis implantation that are improperly positioned, compatibility, improper use of the expansion device and the medullary cavity Cuo,inappropriate choice of the size of prosthesis and improper use of bone cement technology and other relevant non-standard;â‘¡Periprosthetic bone defect should based on the classification of prosthesis loosening, bone graft, whether to carry out reconstruction and the type of prosthesis that will be used.