Clinical Effects Analysis Of Hip Arthroplasty For The Patients With End Stage Renal Disease

Background: Patients with end-stage nephropathy are prone to femoral neck fractures due to long-term use of hormones and abnormal bone metabolism and endocrine.necrosis of femoral head and other diseases.When artificial joint replacement is needed,it has different characteristics compared with conventional hip replacement.Objective:To observe the clinical efficacy of hip replacement in the treatment of patients with end-stage renal disease with hip joint disease using biotype or cement prosthesis.Methods: The clinical data of 19 end stage renal disease patients with hip disease who received total hip arthroplasty or artificial femoral head replacement from June 2014 to March 2017 were retrospectively reviewed.7 males and 12 females were included;the average age was 62.5 years(49-84).There are 10 cases with femoral neck fracture,7 cases with femoral head ischemic necrosis and 2 cases with osteoarthritis.13 cases were conducted total hip arthroplasty(10 hips with biologic type,3 hips with cemented type),and 6 cases were conducted artificial femoral head replacement(2 hips with biologic type,4 hips with cemented type).The follow-up X-ray inspection was taken to observe whether the translucent zone could be seen around the prosthesis,as well as the dynamic changes,and the Harris hip score and SF-36 score were used to evaluate the recovery of joint function and improvement of life quality.Results: Average follow-up time after replacement was 27.9 months.After the last follow-up,the Harris hip function score was 88 ±6.0,excellent in 11 cases,good in 6 cases,fair in 2 cases,poor in 1 case,excellent and good rate was 89.5%.SF-36 score increased from 64.0 ±2.4 before replacement to 83 ±4.8.Complications occurred in 6 cases,exacerbation of heart failure in 1 case,pulmonary infection in 1 case,deep venous thrombosis in lower extremities in 2 cases,hypotension in 1 case during dialysis.The wound was delayed healing in 1 case and recovered after treatment.There were no cases of death in hospital and no complications such as prosthetic loosening dislocation and periprosthetic infection during follow-up.Conclusion: recent follow-up results show that hip arthroplasty can relieve pain,improve joint function and improve quality of life in patients with end-stage nephropathy complicated with hip disease,but it needs careful perioperative management.Choose the reasonable operation method and the proper prosthesis.