Comparative study on operation techniques of tumor type and conventional type femoral prostheses in total hip replacement

Abstract

Objective To compare two techniques of femoral prosthesis positioning and the soft tissues repair during total hip arthroplasty(THA) and enhance the comprehension of the surgery. Methods From January 2012 to January 2016, a series of 90 patients (95 hips) were enrolled in the study, including 53 males(56 hips) and 37 females (39 hips) of hip tumor, femoral head necrosis or femoral neck fractures, while the patients not suitable for operation were excluded. The average age was (55±14)years. The patients were divided into two groups. In the group of tumor femoral prosthesis (group A), there were 12 patients (12 hips). In the group of conventional femoral prosthesis (group B), there were 78 patients (83 hips). During the operation, the femoral prostheses were placed according to the reference of multiple anatomic landmarks, and the soft tissues around the artificial joint were reconstructed as far as possible. The perioperative data such as operative time, blood loss volume, hospital day as well as the Harris hip score were observed. Rank-sum test and chi-square test were applied for statistical analysis. Results The two groups received three to 30 months of follow-up, and the average follow-up time was 21 months. No statistically significant difference was found between group A and group B in the operative time (t=1.014, P>0.05) or blood loss (t=1.922, P>0.05). The hospital day and the Harris hip score showed statistically significant differences between the two groups(t=2.027, P<0.05). The difference between pre-and postoperative Harris hip scores of the two groups was statistically significant(F=4.662 , P<0.05). The difference of Harris hip score between group A and group B was statistically significant(F=2.679 , P<0.05); group B was higher than group A. In the two groups, no leg length discrepancy, dislocation, postoperative infection, aseptic loosening, periprosthetic fracture, nerve injury or other complications was observed. One patient presented abnormal walking in group A, the cause might be the incomplete abductor strength. Conclusions It is a prerequisite for the femoral prosthesis being put at a correct position and for the tissues surrounding the artificial joint been reconstructed to obtain a good hip function after operation. Key words: Arthroplasty, replacement, hip; Tumor; Femur