Use And Analysis Of Rebuilding Prosthesis In Revision Total Hip Replacement

Objective：To investigate and analysis the reasons，clinical use of rebuildingprosthesis, short-term effects and techniques of the revison of the total hip replacementthrough the review of the operations performed in our department during the past fouryears.Data:general information: Between November2008to October2011，a total of29patients collected the revisions of the total hip replacement.Among the patients，15weremale and14were female，with their ages ranging from45to83years and an average ageof63years．The right arthroplasty were13patients and left16patients. The reasons ofprimary operations include fracture of femoral neck are16patients，ischemic necrosis ofthe femoral head are13patients．The methods of primary operations include8patients ofthese underwent the femoral head arthroplasty，and21patients of these underwent totalhip replacement．Prosthesis used in the primary operation included17bone-cement type,11biological fixation type and1mixed type．The time between the primary operation andthe revison of the total hip replacement ranged from l5month to21years，with an averageage of87.66months．Methods: Review the reasons of revisons of the femoral head arthroplasty or the total hipreplacement，and discuss election of rebuilding prosthesis,the short-term effects andtechnical considerations.The post operative clinical results were evaluated with Harrisscoring system of hip.Results：1.There are no occurrence of infection，injury of blood vessel and nerve and DVTafter operation of the patients in short-term．2.The reasons of revisions were as follows:aseptic loosening24(82.76％)，infection4(13．80％)and fracture1(3．40％)after the primary operation．The main causes of revision was aseptic loosening.3.29patients，revisions were followed up for5months to3years，an average of1.7years.All patientsshowed that the original hip pain was relieved obviously,the hip joint function wasimproved evidently.artificial joint was showed favorablely of postoperation byroentgenograms.There are no occurrence of lossing,dislocating，infection and fracture ofthe prosthesis．The Harris scoros before operation ranged from35.80～66.75,with anaverage of51.76,and scores after operation ranged from68.34～89.58,with an average of79.78．The differences between peroperation and postoperation were significant．Conclusion：The main cause of revision after total hip replacement is asepticloosening，and the managements of bone defects wasthe key point．It is efective to userevisable prostheses to treat prostheses loose with defects of femur in short terms．The longterm effects remain to be analyzed．...