Clinical observation of cementless long-stem hip prosthetic replacement for femoral prosthesis loosening with femoral bone defect

doi:10.3877/cma.j.issn.1674-134X.2020.04.005

Abstract

Abstract:

Objective

To investigate the clinical effect of cementless long-stem hip prosthetic replacement for femoral prosthesis loosening with femoral bone defect.

Methods

From January 2011 to January 2015, the patients undergoing hip revision procedures in Xinjiang Shaya County People's Hospital were analysed retrospectively. The patients with femoral handle loose, femoral defect and only revision of femoral prosthesis handle were selected. The patients with infection, problem of acetabulum prosthesis, severe medical diseases and osteoporosis were excluded. A total of 104 cases were enrolled. The patients treated by cementless long-stem hip prosthetic were in the observation group (n = 52). The patients treated by cement hip prosthetic were in the control group (n = 52). The operation time, intraoperative blood loss, hospital stay, fracture healing time and relevant functional scores of the two groups were analyzed by t test. The good rates and incidence of complications were calculated and analyzed by chi-square test.

Results

Harris score, activities of daily living (ADL) score and quality of life (QOL) score were increased in the two groups during the follow-up (control group: t=10.045, 18.185, 15.162, all P<0.05)(observation group: t=13.445, 23.741, 17.324, all P<0.05). The visual analogue scale (VAS) scores in the two groups were lower than those before the treatment (control group: t=48.714, P<0.05) (observation group: t=78.556, P<0.05). During follow-up, Harris score, ADL score and QOL score in the observation group were higher than those in the control group(t=5.267, 5.205, 3.976, all P<0.05), and VAS score was lower than that in the control group (t=8.561, P<0.05). Moreover, the length of hospital stay and fracture healing time in the observation group were shorter(t=4.917, 4.398, both P<0.05). The good rate in the observation group (98.1%) was higher than that in the control group (44.2%), and the complication rate in the observation group (1.9%) was lower than that in the control group (13.5%) (χ²=36.728, 4.875, both P<0.05).

Conclusion

The cementless long-stem hip prosthetic is effective in the treatment of femoral prosthesis loosening with bone defect, and it is a feasible prosthetic option, while the long-term efficacy still needs further observation and verification.

Key words: Arthroplasty, replacement, hip, Reoperation, Hip prosthesis, Femur

Wei Li, Weili Gao, Hongyu Zhou. Clinical observation of cementless long-stem hip prosthetic replacement for femoral prosthesis loosening with femoral bone defect[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(04): 417-422.

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References 21

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	例数	年龄[岁，(±s)]	性别(例，男/女)	部位(例，左/右)	初次手术时间[年，(±s)]
对照组	52	66.2±4.8	31/21	17/35	7.4±1.8
观察组	52	66.7±5.1	32/20	15/37	7.6±1.4
统计值		t ＝0.381	χ²＝0.040	χ²＝0.181	t＝0.655
P值		>0.05	>0.05	>0.05	>0.05

	例数	年龄[岁，(±s)]	性别(例，男/女)	部位(例，左/右)	初次手术时间[年，(±s)]
对照组	52	66.2±4.8	31/21	17/35	7.4±1.8
观察组	52	66.7±5.1	32/20	15/37	7.6±1.4
统计值		t ＝0.381	χ²＝0.040	χ²＝0.181	t＝0.655
P值		>0.05	>0.05	>0.05	>0.05

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)	骨折愈合时间(月)
对照组	52	52.6±7.9	216.4±37.0	20.7±1.2	10.6±1.4
观察组	52	51.2±8.4	213.8±31.5	17.3±0.9	9.3±1.0
t值		1.273	0.952	4.917	4.398
P值		>0.05	>0.05	<0.01	<0.01

组别	例数	手术时间(min)	术中出血量(ml)	住院时间(d)	骨折愈合时间(月)
对照组	52	52.6±7.9	216.4±37.0	20.7±1.2	10.6±1.4
观察组	52	51.2±8.4	213.8±31.5	17.3±0.9	9.3±1.0
t值		1.273	0.952	4.917	4.398
P值		>0.05	>0.05	<0.01	<0.01

组别	例数	疼痛		功能		关节活动度		畸形		总评分
组别	例数	治疗前	随访时	治疗前	随访时	治疗前	随访时	治疗前	随访时	治疗前	随访时
对照组	52	19.2±1.5	35.7±3.4^a	21.3±2.0	33.8±4.1^b	2.3±0.4	3.1±0.3^c	2.1±0.3	2.8±0.2^d	44.9±8.5	75.4±9.6^e
观察组	52	19.0±1.7	41.8±1.6^f	21.5±1.8	43.1±0.7^g	2.4±0.3	3.8±0.4^h	2.1±0.2	3.5±0.3ⁱ	45.0±9.2	92.2±4.1^j
t值		0.337	4.709	0.319	6.032	1.007	5.258	0.369	5.508	0.043	5.267
P值		>0.05	<0.01	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01	>0.05	<0.01

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