Comparison Research Of Short And Medium Period Effect Of Reserving Femoral Neck And Non-reserving Cementless Prosthesis

Objective: The total hip arthroplasty has been widely used to cure suchdiseases: hip fractures, late stage femoral head necrosis,hip osteoarthritis,acetabular dysplasia and tumor etc. Each year, a huge number of patientsrequire such operation. Patients recover their joint function, relieve pain andimprove their quality of life through accepting TOA. In1983, Italian professorPipino designed the Reserving Femoral Neck Prosthesis, which brought aboutfine clinical results. However, introduction and Application of the collumfemoris preserving in China is late.The purpose of this paper is to make surveyon the advantages and disadvantages of Reserving Femoral Neck Prosthesis,actual clinical effect of Chinese patients who accepted such operation bycomparing with Non-reserved femoral neck prosthesis for three years.Methods:1Choose the patients suffering from the late stage femoralhead necrosis and non-infectious hip osteoarthritis, who accepted treatment inthe Third Hospital of Hebei Medical University. Imagine examination showsthat all the patients require the total hip arthroplasty. Standard:1,Formulating rate of patient sex of the two groups: each group shall include21males,9females.2They shall be at age of55to65;3Their BMI <24;4preoperative Harris hip score <60points;5The range of preoperative hipmotion <90°.6VAS score≥3;7Patients has no treatment with hormone.Set the patients who shall undergo the TOA with femoral neck reserved forgroup A and the patients who shall undergo the TOA with non-reservedfemoral neck for group B. The two groups patients shall be operated on by thesame surgeon, the surgical incision shall be on the hip posterior approach. Allpatients shall be under general anesthesia. Preoperation, intraoperation andpostoperation, patients shall be given the same treatment. Measuring two groups of patients with body mass index, preoperative Harris hip scores,preoperative hip range of motion, preoperative VAS scores; operation time,intraoperative blood loss, the rate of hip incidences; postoperativeaccumulated amount of bleeding, VAS scores on the12thafter the operation.Measuring Harris hip scores, hip range of motion, VAS pain scores in the3thmonth, the12thmonth and the36th month. With SPSS17.0, we will seewhether there will be differences between the two groups as well as prosthesisloose of the Anteroposterior pelvic X-ray, in accordence with IDES, after theiroperations in the3th month, the12thmonth and the36th month. We will alsoaccount for the rate of deep vein thrombosis, hip incidences such as infection,fracture etc.Results:1There is no sexual difference between the two group with chi-square test:(P=1).2There is no BMI scores difference between the two group with in dependsamples of non-parametric test (p=0.355).3There is no age difference between the two groups with t test (P=0.594).4There is no differences of the preoperative Harris hip scores, range ofmotion, VAS scores between the two group with K independ samples ofnon-parametric test(P=0.848,p=0.900,0.824)5Operation time of group A is55.5±5.728minutes, group B is54.57±4.621minutes, there is no difference between the two groups with t-tests (P=0.49).6Intraoperative blood loss of group A is477.57±95.519ml, group B is319.87±58.419ml, there is no difference between the two groups with t'-test(P=0.916).7Postoperative bleeding of group A is497.6±129.664ml while group B is319.87±58.419ml.Group A of that is higher than that of group B witht'-test(P=0).8VAS on the postoperative12thday, group A of score is higher than that ofgroup B with independ samples of non-parametric test (P=0).9In the postoperative3rd months, there is no difference of Harris hip score, VAS score between two groups, while range of motion of group A washigher than group B with K independ samples of nonparametrictest.(P=0.055,p=0,p=0.813)10In the postoperative12th months, group a of Harris hip score is higherthan that of group B, while range of motion of group A is higher thangroup B,Group A is less than group B in VAS score with K independ samplesof non-parametric test.(P=0.001,p=0,p=0.016).11In the postoperative12th months, group A of Harris hip score is higherthan that of group B, while range of motion of group A is higher thangroup B,group A is less than group B in VAS score with K independ samplesof non-parametric test (P=0,p=0,p=0.021).12There is no pre-operative and postoperative hip incidences happened, andthe rate of hip incidences and deep vein thrombosis is0.Conclusions:1There is more bleeding and serious pain postoperative with reserved femoralneck prosthesis, because of the Flow channel design of the prosthesis.2The clinical efficacy of reserved femoral neck prosthesis in the mid andshort-term is superior to non-retention of the femoral neck type, mainly due tothe design features of the prosthesis designed which is applicable to theChinese. Reserved femoral neck prosthesis is apply to younger patients.3Compared with the non-reserved neck prosthesis, the reserved femoral neckprosthesis application has its restriction. The reserved femoral neck prosthesisshould take into account factors such as femoral neck and Bone modulus ofelasticity decrease,which set a higher requirements for doctors.