| Objective:Explore the relationship between the clinical characteristics of patients undergoing total hip replacement for the first time and the reasons for the failed revision,determine the factors that affect the reasons for the clinical revision,and prevent probable causes of revision for patients exposed to high-risk factors during the initial surgical replacement The adjustment of the treatment plan can achieve the purpose of reducing the risk of surgical failure.Methods:Find and collect 205 patients who underwent hip revision surgery from January2015 to December 2018 in the Department of Osteoarthrology,the First Affiliated Hospital of Nanchang University,and summarize the detailed clinical data of the patients in the table to describe the clinical characteristics of the revised patients To organize and analyze the clinical characteristic data that may affect the reason for the revision of patients,SPSS 22..0 software was used to analyze the statistical data.Resu Its:This study is a retrospective study,including 205 cases of artificial hip revision.Among these 205 patients,female patients are more n=111,accounting for 54.1%,male patients n=94,accounting for 45.9%,the average age of revision is 65.88,the standard deviation is 11.193,the fastest after one day,the longest time is 28.9 years,The average hip prosthesis survived 7.9 years,with a standard deviation of 6.05 years.Among the causes of hip revision,the aseptic loosening of the prosthesis(n=104,50.7 %)accounted for the highest proportion,followed by periprosthesis infection(n=39,19.0%),fractures around the prosthesis(n=27,13.2%)and other causes(total n=35,8 cases of dislocation of the prosthesis,11 cases of lining wear,8 cases of poor prosthesis position,and femoral stem fracture 3 cases,4 cases of intractable hip pain after replacement,1 case of ceramic lining rupture),accounting for 17.1%.In the multi-factor regression analysis,no obvious influencing factors for aseptic loosening of the prosthesis were found;for patients with fractures around the prosthesis,patients with a history of previous cerebral infarction(OR value 21.804,95%CI: 2.304-206.362)were more likely to have fractures around the prosthesis,and Comparing patients with an age >70 years for the first replacement surgery,40-55 years old(OR=0.146,95%CI:0.025-0.834),55-70 year old patients(OR=0..194,95%CI: 0.040-0.952)The risk of fractures around the prosthesis is lower.We believe that patients >70 years of age have a higher risk of fractures around the prosthesis,patients >70 years of age have a higher risk of fractures around the prosthesis.Among infections around the prosthesis,diabetic patients(OR=5.678,95%CI: 1.106-29.151)infection around the prosthesis is more likely to occur,and the risk of infection is 5.6 times that of normal people.The first replacement surgery in the top three hospitals(OR=0..274,95%CI: 0.085-0.877)is easier to avoid infection than patients in the top three hospitals.The risk of infection around the prosthesis of the top three hospitals is only 27.4%.Conclusion:The cause of total hip revision is correlated with the clinical characteristics of patients with initial hip replacement.The influencing factors for fractures around the prosthesis include a history of previous cerebral infarction,age >70 years;the influencing factors for infections around the prosthesis include diabetes,the first time below the top three replacement experience. |
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