Comparison Of The Clinical Efficacy Of CFP Prosthesis And Ribbed Prosthesis In Total Hip Replacement

ObjectiveCompare the clinical efficacy of collum femoris preserving(CFP)prosthesis and Ribbed prosthesis in total hip arthroplasty(THA),in order to provide a reference for the selection of prosthesis types in total hip arthroplasty.MethodsA retrospective analysis of 77 patients(79 hips)who underwent THA from January 2015 to July 2017 was divided into CFP group[41 patients(43 hips)]and Ribbed group(36 patients),respectively;aged(53.7±7.9)and(5.8±5.9)years.Patients were assessed using the Harris hip score(HHS)and Western Ontario and McMaster University Osteoarthritis Index(WOMAC).The length of surgery,intraoperative blood loss,hemoglobin values,postoperative complications were recorded in all patients.To assess osteolysis,cortical bone hyperplasia and ectopic ossification around the prosthesis according to the Gruen zones and Delee zones to evaluate whether the femoral prosthesis was in a neutral position.Engh criteria was used to evaluate the stability of bone-prosthesis interface.ResultsThe mean follow-up times of the CFP and ribbed groups were(47.0±7.2)and(55.6±7.9)months,respectively.No cases lost during the follow-up.Among them,41 patients(43 hips)in the CFP group,24 males(26 hips),and 17 females(17 hips),BMI of 23.9±2.2kg/m~2,and an average age of 53.7±7.9 years;36 patients(36 hips)in the Ribbed group,15 males(15 hips),and 21 females(21 hips),BMI of 24.2±2.1 kg/m~2,and an average age of 55.8±5.9 years.There were no significant differences in gender,age,and BMI between the two groups(P>0.05).there was no significant difference in preoperative HHS score and WOMAC score between the two groups(P>0.05).The average operation time of the CFP group was 69.3±22.5 minutes,and the average operation time of the Ribbed group was 70.3±21.0 minutes.The intraoperative blood loss was 152.8±91.4ml in the CFP group and 162.4±96.3ml in the Ribbed group.There was no statistically significant difference between the two groups in operation time,intraoperative blood loss,and hemoglobin difference(P>0.05).The hemoglobin difference referred to the difference between the hemoglobin value measured 48h after the operation and the hemoglobin measured before the operation,and the two groups were 29.1±14.1 g/L and 29.5±12.5g/L,respectively.There was no significant difference in blood loss and hemoglobin difference(P>0.05).The HHS score of the CFP group was higher than that of the Ribbed group at 1 year after operation,with a significant difference(CFP group 88.7±4.2 VS Ribbed group 85.7±3.3,P<0.01).There was no significant difference in HHS score between the two groups at the last follow-up(P>0.05).The WOMAC score of the CFP group was lower than that of the Ribbed group at 1 year after operation,with a significant difference(CFP group 9.1±2.0 VS Ribbed group 10.2±1.9,P<0.05).There was no significant difference in WOMAC score between the two groups at the last follow-up(P>0.05).The HHS scores and WOMAC scores of the two groups were significantly improved after the operation(P<0.05).Postoperative complication of CFP group included 1 case of intraoperative periprosthetic fracture,1 case of early hip dislocation,1 case of thigh pain,2 cases of deep venous thrombosis.Ribbed group included 2 cases of intraoperative periprosthetic fracture,1 case of thigh pain,3 cases of deep venous thrombosis,there was no significant difference between the two groups(P>0.05).The cases of leg-length differences>10 mm in the CFP group(8 cases)were significantly higher than that in the Ribbed group(1 case),there was significant difference between the two groups(P<0.05).ConclusionCFP prosthesis and Ribbed prosthesis can achieve similar clinical efficacy in total hip arthroplasty.CFP prosthesis is significantly better than Ribbed prosthesis in terms of early stage.However,the CFP prosthesis is more prone to causing leg-length differences,which might be accompanied by some technical problems.During the follow-up,there were no adverse events such as prosthesis loosening,prosthesis infection and so on.As for survival rates,there still requires long-term follow-up.