Medium-term Evaluation Of Aseptic Loosening Of Artificial Hip Revision

Objective:The purpose of this retrospective study was to analyze the medium-termefficacy aseptic loosening of artificial hip revision of28cases.Methods:From December2008to December2012, thirty-five consecutive patientswith prosthesis loosening had been selected, and all cases had been treated by totalhip revision. Seven cases were septic loosening which were not belong to the study.The preoperative history, physical examination, laboratory tests, imaging studies, etc.of28cases were detailed, preoperative loosening were cleared, and28patients wereprosthesis aseptic loosening after hip arthroplasty through AAOS guidelines. Accordingto the patient’s acetabulum and femoral defect types, the most appropriate prosthesisand revision surgery program was been chosen.28cases (28hips) were diagnosed withartificial acetabular prosthesis and aseptic loosening of the femoral prosthesis.According Paprosky bone loss classification: there were six cases of type-I withacetabular bone loss,11cases of type-IIA,8cases of type-IIC,2cases of type-IIIA,1case of type-IIIB;12cases of type-I with femur bone defect,14cases of type-II,2casesof type-IIIA of this group patients. All patients were treated by total hip arthroplasty atone-stage(ie, hip loosening prosthesis was completely removed, total hip arthroplasty).Bio-based hip acetabular cup was used in22hips, cemented acetabular cup was usedin six hips, bio-femoral hip stem was adopted in28hips. The preoperative andpostoperative Harris score and VAS score were compared. Radiographic outcomes,complications, erythrocyte sedimentation rate and C-reactive protein were followed-upafter the revision.Results:28cases (28hips) were obtained with complete follow-up information. Harrisscore improved from preoperative (31.4±11.6) to (89.2±3.3) after two years; VASscores decreased from preoperative (6.21±0.53) to (1.61±0.15) at the time of twoyears later. The Harris score was improved significantly(P<0.05). The occurrence of complications:one case had femur subtrochanteric fractures during surgery, leather topwas worn when femoral canal reamed femoral anterior arch was occured in one case insurgery. One case occured that X-ray showed the top of the hip acetabulum focalosteolysis at the time of1year after surgery. The rest patients had no fracture,infection, deep vein thrombosis and other complications, periodic review X-rays wereprompted no prosthesis loosening, osteolysis phenomenon, periodic review ESR,C-reactive protein after six months were all normal.Conclusions:The medium-term efficacy of total hip revision in treating asepticloosening was satisfied.