| Objective:To study the application of the prosthsis and following-up patients who underwent total hip arthroplasty (THA) with collum femoris preserving (CFP) and to investigate the remaining bone mass of the femoral neck and metaphysis, the influence of the parameters of the hip with with the length the remaining femoral neck, the choice of the curvature and the medol of the prothesis and the clinical effec.Methods:From April 2008 to September 2010,47cases (59 hips) of hip joint disease were treated with artificial THA with CFP. To review the score of Harris and the caput collum diaphysis angle (CCD) preoperative:the main points of the remaining of the femoral neck,, the choice of the curvature and the medol of the prothesis and the complication intraoperative. To measure the parameters of the hip when following-up: 1.the length of the remaining femoral neck,2. CCD,3.the offset of the femur.4.the included angle of the femur and the stem,and analysis the relationship of the length of the remaining femoral neck and the parameters of the hip.To compare the the differences among the group with diffent ages and the following time. To observe the adherence of the distant stem and medullary cavity of the femur, the change of bone density of the femur,the reablement of THA.Results:32 patients (40hips) were followed up for 6--35monthes with an average time of (18.85±8.59) monthes, and the average age was (52.82±12.09) year-old. Resection of the lesion femoral head only and achieve the the remaining bone mass of of the femoral neck,the metaphysis and proximal of the femur and the bone trabecula. Among the patints,90%(36 hips) choice the models SMALLand MEDIUM, curvature A 38 hips, curvature B 2hips. The average length of the remaining femoral neck was (20.82±4.62)mm.CCD postoperative was (134.85°±8.59°),the average offset was (37.62±7.61)mm.the average included angle of the femur and the stem was (-1.89°±3.29°).Statistical analysis showed there was no significant difference between preoperative and postoperative CCD.The Pearson product-moment correlation coefficient was calculated, R=-0.692(p<0.01),there might exist negative correlation between CCD and the length the remaining femoral neck; R=-0.569(p<0.01),there might exist negative correlation between CCD and offset; R=0.675(p<0.01),there might exist positive correlation between offset and he length the remaining femoral neck; R=0.782, (p <0.01).there might exist positive negative correlation between the length the remaining femoral neck and the included angle of the femur and the stem.Harris score improved from (45.42±17.01) preoperative to (95.10±2.99) at the last following-up. All were excellent. Statistical analysis showed there was no no significant difference between different age groups and different following-up period groups. The flection all hip joints can reach 90 degrees or more, aii patients can walk independence, Among all the patients there were 5 patients (6 hips) who can squat. There were no loosening and dislocation among all hips.Conclusion:THA with CFP prosthesis retained a large number of femoral neck and proximal femur bone, achieved the reconstruction of the hip joint and biomechanics conduction. Especially the reservation of the femoral neck re-established the CDD angle the femoral offset and reduced the incidence of proximal femoral stress shielding. The early stage study indicated a good clinical effect who underwent THA with the CFP prosthesis. All patients achieved the aims of reliefing the pain of the hip joint, restoring the joint function and improving the quality of the life. |
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