The Clinic Study Of Lateral Femoral Cortical Windowing In Total Hip Revision Surgery

Objective:To explore the clinic effect of lateral femoral cortical windowing and in the revision total hip arthroplasty.Methods:Select34cases who underwent revision total hip arthroplasty from January2005to March2013in the department of Orthopedics in the Third Hospital of Changsha.The patients were divided into lateral femoral cortical windowing group (n=20) and no-windowing group (n=14). The operation time, intraoperative bleeding, postoperative drainage volume and hospital days were recorded and compared respectively, so did the postoperative complications such as infection, fracture of wires, fracture nonunion, prosthetic loosening, and dislocation et al. All of the dates were analyzed by SPSS19.0statistical software. The operation time, intraoperative bleeding, postoperative drainage volume, hospital days and postoperative Harris hip scores of two groups were performed by two-sample/group t-test. The incidence of complications was performed by the Fisher probabilities in2×2table data.Results:The windowing group patients were followed up for12～56months, and the no-windowing group patients were followed up for20～96months.The results of operation time, introperative bleeding and postoperative drainage volume in two groups were196.5±37.5minutes, 238.2±40.0minutes (P=0.004);882.5±234.7ml,1121.4±359.9ml (P=0.025);268.0±147.95ml,298.4±57.3ml (P=0.034) respectively, which have statistical significance. The complications in two groups were2and5cases, which have statistical significance(P=0.037). The hospital days of two groups were33.95±19.07days and45.86±37.27days respectively, which have no statistical significance(P=0.23). The bone healing time of lateral femoral cortical windowing group was22.20±3.07(17-28weeks) weeks,100%union rate. The Harris hip scores of two groups the first year following sugery were85.9±4.99scores and81.9±5.15scores, which have statistical signiflcance(P=0.031).Conclusion:(1) In the revision total hip arthroplasty, lateral femoral cortical windowing and no-windowing group could both take out prosthesis stem and bone cement, and achieve good postoperative hip function.(2) Compared with no-windowing group, lateral femoral cortical windowing can take out the distant bone cement more easily, which has less operation time, introperative bleeding and complications and better postoperative hip function.(3) It has not been proved that the windowing group has more advantages than no-windowing group in shortening hospital days.