Proximal Femoral Reconstruction In Total Hip Arthroplasty For Hip Deformity After The Sequelae Of Septic Arthritis Of The Hip

Objective To evaluate the feasibility of total hip arthroplasty combined with proximal femoral reconstruction in the treatment of sequelae of septic arthritis of the hip with proximal femoral deformity,and to observe the early clinical effects,imaging results and surgical complications.Methods This study was a evaluator-blind,prospective,non-controlled,single-center observational trial.36 patients(37 hips),who needed initial total hip replacement due to diagnosed suppurative hip arthritis,were recruited from the department of orthopedics,provincial hospital affiliated to anhui medical university,between 1 June 2015 and 31 December 2017.And 25 of them(25 hips)were included in the study.After 12-24 months of follow-up(an average of 20±4.2months),25 complete clinical and imaging follow-up data were obtained to evaluate the early follow-up results of proximal femoral reconstruction in total hip arthroplasty for hip deformity after the sequelae of septic arthritis of the hip.Results The postoperative patients had significant relief of pain and improvement in walking function.Before surgery,25 patients had positive hip Trendelenburg sign while only 2 patients had positive hip Trendelenburg sign after surgery.One patient had transient sciatic nerve palsy,2 patients had postoperative hip dislocation,and 1patient had large trochanteric bursitis.No patient infection occurs,all ? healing of incision,no aseptic loosening was observed.The fracture healed within 3.5 ~ 6.5months,with an average of(4.1±0.7)months.Preoperative Harris score was(37.9±4.9),and Harris score was improved to(86.9±3.7)3 months after surgery,which was statistically significant(t= 39.09,P= 0.00).The unequal lengths of the lower limbs before surgery were(4.3±1.1)cm,and the unequal lengths of the lower limbs were(0.6±0.3)cm 1 day after surgery,the difference between the two lower limbs was statistically significant(t= 67.53,P= 0.00).Conclusion Total hip arthroplasty combined with proximal femur reconstruction in the treatment of hip deformity after suppurative hip arthritis has reliable efficacy and less complications,which is worthy of promotion.