| Objective: To investigate the mid-and long-term results and complications of hip resurfacing arthroplasty(HRA),and analyze its related influencing factors Materials and methods: 64 patients 81 hips who received HRA and had complete clinical and imaging data in our institution from June 2005 to January 2012,including 35 males(44 hips)and 29 females(37 hips).The average age was(48.3±10.4)years,ranging from 20 to 65 years.Preoperative diagnoses included osteoarthritis secondary to the developmental dysplasia of the hip(23 cases 29 hips),necrosis of the femoral head(19 cases 22 hips),osteoarthritis(8 cases 10 hips),rheumatoid arthritis(5 cases 9 hips),ankylosing spondylitis(6 cases 6 hips),pigmented villonodular synovitis(2 cases 2 hips),and Otto's disease(1 case 1 hip).The components included Conserve Plus 36 hips,ASR 6 hips,and BHR 39 hips.The preoperative and postoperative hip function were evaluated by Harris score,The University of California at Los Angeles(UCLA)score,and hip range of motion.The area,volume,and location of femoral head lesions were evaluated comprehensively by hip radiographs,CT,or MR before surgery,combining the intraoperative hip conditions,and then the choice of HRA was determined.Postoperatively,the radiographic results including acetabular inclination angle,stem shaft angle,component loosening,bone resorption,and heterotopic ossification were observed through standard anteroposterior and frog lateral view's radiographs.Results: The mean follow-up was for(8.0±2.2)years(range,5.0 to 12.8 years).The preoperative mean Harris score was 41.93±9.10 points(ranged,16 to 68 points).The mean postoperative Harris score was(92.98±4.72)points(ranged,65 to 100 points),higher than properative score,at the last visit.The preoperative UCLA pain,walking,function,activity scores were(3.57±1.23)points,(5.99±1.30)points,(5.00±1.01)points and(3.84±1.41)points,respectively.The postoperative UCLA pain,walking,function,activity scores were(9.37±0.86)points,(9.14±1.01)points,(8.77±1.09)points,(6.47±1.27)points,respectively.Compared with the preoperative UCLA scores,all the respective values of postoperative UCLA scores were improved.The mean acetabular inclination angle was 44.04°±3.79°,ranging from 40° to 53°.And the mean stem shaft angle was 138.74°±4.88°,ranging from 129° to 150°.The preoperative hip flexion range was 86.73°±17.16°,the adduction and abduction range was 36.30°±15.06°,and the medial and lateral rotation range was 23.64°±9.32°.The postoperative ranges of hip flexion,adduction and abduction,and medial and lateral rotation were 124.88°±14.68°,77.22°±14.34° and 78.09°±13.38°,respectively.The postoperative three parameters above of the hip range of motion were higher than the ones before surgery.There were 6 short-term complications,including one revision of femoral neck fracture after femoral head necrosis,one deep femoral artery and saphenous nerve injuries during surgery,one intraoperative femoral nerve injury,2 cases of heterotopic ossification,and one case of hip pain.There were 2 mid-and long-term complications,one had pain in the inguinal region of the hip,and one occurred cyst in the posterior greater trochanter.There were no other complications such as infection,dislocation,and component loosening.The five-year and ten-year implant survivorship both were 98.77%,while that of male and female patients was 97.73% and 100.00% at ten years,respectively.Conclusion: The Harris score and UCLA scores after HRA were significantly improved,and postoperative the ranges of hip motion were higher than that before surgery.Patients with different etiologies can obtain satisfactory long-term results and implant survivorship after HRA.There are complications such as femoral neck fracture,heterotopic ossification and hip pain after HRA,but strict indications and surgical techniques can reduce the incidence of complications.Gender,femoral head diameter,and surgical techniques may be important factors affecting the long-term implant survival after HRA. |
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