| Background:Total hip arthroplasty is an effective operation for curing hip illness of final stage, relieving pain and improving the life quality, which comes to an ordinary orthopaedic surgery. How to restore femoral offset precisely in THA is a problem we are faced, and it plays an important role in balanc ing the soft tissue around the hip, which directly affects the functions of joint. Among most of the affecting factors, neck-shaft angle of femoral prosthesis occupies a significant position. Although the manufacturer of one brand can provide two different femoral pro sthesis with different neck-shaft angle, no similar design has been introduced internally. In addition, Comparison on reconstruction of femoral offset in THA between prosthesis with different neck-shaft angle has been rarely reported. Objective:This paper summarized and compared the clinical data of patients who underwent total hip arthroplasty by femoral prosthesis with different neck-shaft angle, so as to discuss the reconstruction results of femoral offset, to find more clinical practice for choice of prosthesis in total hip arthroplasty in Chinese. Methods:Between January 2012 and December 2013, 101 patients undergoing unilateral THA accorded with selection criteria were selected for a retrospective study in The First Hospital of Jilin University. The patients were divided into two groups: during total hip arthroplasty, femoral prosthesis with neck-shaft angle 135°were used in 52 patients(Group A)and prosthesis with neck-shaft angle 127°were used in 49 patients(Group B).The postoperative Harris score was recorded to evaluate the c linical outcomes;and the femoral offset of contralateral and operated side、the change value of femoral offset(x FO)、the ratio of x FO to the offset of contralateral s ide(sd FO)、the number of patients whose sd FO more than 15%or less than-15%(outliers)、leg discrepancy were measured for statistical analys is. Results:There were no significant difference in gender、age、neck-shaft angle preoperative、leg discrepancy、Harris score preoperative between two groups. All patients were followed up 12-23 months(mean 32 months). Operative inc ision healed by first intens ion in two groups;no complications such as infection、dislocation and revis ion were found. The Harris score at last follow-up were s ignificantly improved when compared with preoperative score(P<0.05),but there was no significant difference between two groups.The x FO and sd FO of Group B(x FOb 5.89mm±5.71 mm, sd FOb 21.01%±20.22%) were significantly largier than those of Group A(x FOa 1.84mm±5.74 mm, sd FOa 8.58%±19.47%).The number of outliers was 21 in Group A and was 33 in Group B, showing s ignificant difference(P=0.005).And significant improvements in leg discrepancy were found 3 months postoperative in two groups(P<0.05). Conclusion:1.Both femoral prosthesis with different neck-shaft angle can restore femoral offset well.2.Both femoral prosthesis with different neck-shaft gain s imilar early clinical outcomes after THA.3.The Stryker Trident femoral prosthesis with 127°neck-shaft angle may have the tendency to enlarge femoral offset. |
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