Comparison Of Clinical Effects Of Total Hip Arthroplasty In ARCO Stage Ⅲ And Ⅳ Stages Of Osteonecrosis Of The Femoral Head

Objective: to compare and analyze the clinical effect of total hip arthroplasty in patients with osteonecrosis of the femoral head in ARCO stage III stage and IV stage.Methods: 481 patients with osteonecrosis of the femoral head who underwent total hip arthroplasty in the Department of Orthopaedics,the third Hospital of Hebei Medical University from January 2014 to December 2017 were collected and classified according to the preoperative stages of the joint study of circulatory orthopaedics.According to ARCO staging,there were 146 cases in stage Ⅲand 335 cases in stage Ⅳ.Statistical methods were used to compare and analyze the average operation time,average intraoperative blood loss,postoperative hospital stay,hip range of motion before and one year after operation,VAS score and Harris hip score between the two groups.Results: statistical analysis showed that there was no significant difference in the average operation time between the two groups(P=0.178).The average intraoperative blood loss in the ARCO stage III stage hip replacement group was less than that in the IV stage hip replacement group(P=0.009),the postoperative hospital stay in the former group was shorter than that in the latter group(P=0.018),and there was no significant difference in postoperative Harris hip score between the two groups(P=0.062).There was no significant difference in postoperative VAS score between the two groups(P=0.173).The postoperative hip range of motion,Harris hip score and VAS score in both groups were significantly higher than those before operation(P<0.05).The preoperative hip range of motion decreased with the progression of osteonecrosis of the femoral head(P<0.05),and was positively correlated with the postoperative hip range of motion(correlation coefficient =0.375,R2 = 0.242).Conclusions: the progress of ONFH has a negative effect on the range of motion of hip joint before operation and after total hip arthroplasty.When choosing the timing of hip replacement with ONFH,the adverse effect of postponing total hip arthroplasty on the postoperative range of motion of the hip joint should be taken into account.