Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2007
[Total hip arthroplasty in adult patients with osphyarthrosis due to hip infection sequela].
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Hu Yihe, Wang Xian, Li Kanghua
Аннотация
OBJECTIVE: To evaluate the curative effect of the total hip arthroplasty on the adult patient with osphyarthrosis due to hip infection sequela.
METHODS: Fifteen patients (7 males, 8 females; age, 36-56 years) with osphyarthrosis due to hip infection sequela underwent the total hip arthroplasty from May 2000 to March 2005. The patients were aged 8-15 years, averaged 11.3 years, when they began to suffer from osphyarthrosis. Their infection was interrupted for 23-44 years (average, 29.5 years) after they were given the total hip arthroplasty. Before operation, all the patients had anchylosis at the different degrees and the total activity range of the hip joint was 30-110 degrees. Among the 15 patients, 4 had the limb-length discrepancy of 2-6 cm (average, 3.8 cm) and 2 had a severe scar after the sinus was closed. All the patients received the total hip arthroplasty performed by the senior surgeons. The small straight stem and the congenital dysplasia of the hip prosthesis were used in 13 patients, the other 2 were given the ordinary prosthesis combined the structural bone grafting. Two fixation patterns were respectively used in the cementless group (4 patients) and the cement group (11 patients). The patients in the cementless group began to do the partially-loading exercise at 3-4 weeks after operation; the patients in the cement group, 2 weeks after operation. The 2 patients with the structural bone allografting began to do the partially-loading exercise 12 weeks after operation.
RESULTS: The germiculture and the pathological examination had a negative result in the tissues removed during operation. In the 4 patients with the shortened limbs, the limb-length discrepancy was less than 1.3 cm. The follow-up for 49 months on average (range, 16 -72 months) showed that the Harris score increased from 46 points on average preoperatively to 90.5 points on average postoperatively. None of the patients had recurrent infection or injuries in the nerves and the blood vessels in the hip or aseptic loosening of the prosthesis.
CONCLUSION: The total hip arthroplasty in an adult patient with osphyarthrosis due to hip infection can achieve a satisfactory curative effect in the early stage. The patient's pain can be effectively relieved, and the problems of the poor motion degree of the hip joint and the limb-length discrepancy can be effectively solved. Using the small acetabular prosthesis and the structural bone grafting can sufficiently reconstruct the anatomic acetabulum. If necessary, the small straight stem and the congenital dysplasia of the hip prosthesis can be used in the patient with severe deformity of the proximal femur.
METHODS: Fifteen patients (7 males, 8 females; age, 36-56 years) with osphyarthrosis due to hip infection sequela underwent the total hip arthroplasty from May 2000 to March 2005. The patients were aged 8-15 years, averaged 11.3 years, when they began to suffer from osphyarthrosis. Their infection was interrupted for 23-44 years (average, 29.5 years) after they were given the total hip arthroplasty. Before operation, all the patients had anchylosis at the different degrees and the total activity range of the hip joint was 30-110 degrees. Among the 15 patients, 4 had the limb-length discrepancy of 2-6 cm (average, 3.8 cm) and 2 had a severe scar after the sinus was closed. All the patients received the total hip arthroplasty performed by the senior surgeons. The small straight stem and the congenital dysplasia of the hip prosthesis were used in 13 patients, the other 2 were given the ordinary prosthesis combined the structural bone grafting. Two fixation patterns were respectively used in the cementless group (4 patients) and the cement group (11 patients). The patients in the cementless group began to do the partially-loading exercise at 3-4 weeks after operation; the patients in the cement group, 2 weeks after operation. The 2 patients with the structural bone allografting began to do the partially-loading exercise 12 weeks after operation.
RESULTS: The germiculture and the pathological examination had a negative result in the tissues removed during operation. In the 4 patients with the shortened limbs, the limb-length discrepancy was less than 1.3 cm. The follow-up for 49 months on average (range, 16 -72 months) showed that the Harris score increased from 46 points on average preoperatively to 90.5 points on average postoperatively. None of the patients had recurrent infection or injuries in the nerves and the blood vessels in the hip or aseptic loosening of the prosthesis.
CONCLUSION: The total hip arthroplasty in an adult patient with osphyarthrosis due to hip infection can achieve a satisfactory curative effect in the early stage. The patient's pain can be effectively relieved, and the problems of the poor motion degree of the hip joint and the limb-length discrepancy can be effectively solved. Using the small acetabular prosthesis and the structural bone grafting can sufficiently reconstruct the anatomic acetabulum. If necessary, the small straight stem and the congenital dysplasia of the hip prosthesis can be used in the patient with severe deformity of the proximal femur.