The Clinical Effect Of Total Hip Arthroplasty (THA) For Patients With Severe Osteoporosis

Background：With the increasingly aging of the population, more andmore patients suffer from serious osteoporosis. However, total hipreplacement arthroplasty (THA) can improve their life quality and makethem get back to the normal life. It has been an effective and well-receivedcommon operation by most patients and their relatives.Objective：To observe the effect of THA for patients with seriousosteoporosis and the circumstances of postoperative complication and tooffer support of experience and guidance of theory for the future clinicalwork.Method： In the research, the patients were investigated byretrospective case-control method. We had a close survey of the242patientsreceiving the THA treatment in certain hospital from September2007toSeptember2011. The Male/Female ratio in the242patients is1.25:1. Theiraverage age is67.2, with the age distributing from48to83. There are278with the THA treatment in all, including206cases with the single hipreplacement and36cases with the double hip replacement. The primary disease–hip fracture totalizes110, accounting for45.45%, the primarydisease—osteoarthritis totalizes85, accounting for35.12%, the primarydisease—ankylosing spondylitis (AS) totalizes22, accounting for9.09%and the primary disease—rheumatoid arthritis (RA) totalizes25, accountingfor10.34%. All the patients were diagnosed as serious osteoporosis,including192（79.34%）patients with the primary osteoporosis,43（17.77%）patients with the secondary osteoporosis and7（2.89%）patients with the idiopathic osteoporosis. All the patients exceptthose with femoral intertrochanteric fracture and ankylosing spondylitis usethe incisal opening of Waston-Jones approach and the acrylic cementprosthesis replacement. All the patients received follow-up visits and thetreatment of anti-osteoporosis for long. We put down their Harris hip scoresbefore the operation,7days,3months and6months after the operation, andalso theconditionoftheirhip’s rangeofmotion.WiththeMedicalOutcomesStudy Short form36, we can investigate their variation of life quality beforethe operation and6months after the operation and thus access their variationof life quality.Result： All incisions were primary healing, without the commonnon-specific complications like the nosocomial infection and Incision split.The shortest time of the follow-up is1year and8months while the longest is6years and5months, with the average4years and5months. The varyinglengths of time are mainly due to the death or loss of follow-up visits of patients. Harris hip score before the operation is38.24and the average scoreincreases little by little3months and6months after the operation. Theimprovement rate and the patients’ satisfaction rate are86%and89%respectively. After the long anti-osteoporosis treatment, all the patients feltmuch better, and their life quality improved compared with the conditionbefore the operation.Outcome：The patients with the serious osteoporosis had differentdegrees of damage. After the THA operation, the patients’ life qualityobviously improved and anti-osteoporosis treatment can reduce theprobability of complication and readmission.