Clinical effect of salvage hip arthroplasty in treatment of internal fixation failure after hip fracture surgery
Objective To observe the clinical effect of salvage hip arthroplasty in the treatment of internal fixation failure after hip fracture surgery.Methods A retrospective analysis was performed on 33 patients with artificial hip arthroplasty for inter-nal fixation failure after for hip fracture operation from February 2014 to October 2023 was conducted.The position,angle,size,stability of the femoral and acetabular prosthesis,and limb length difference were evaluated according to the follow-up X-ray films.The VAS score of pain and Harris score of hip joint function were also recorded.The bone ingrowth of the prosthesis was observed by determining whether the width of the radiolucent lines in 7 zones around the femoral prosthesis and 3 zones around the acetabular prosthesis exceeded 2 mm and 50％of the total length.Whether there were complications such as prosthesis dis-placement and subsidence,osteolysis,heterotopic ossification,and secondary fracture were determined,and relevant laboratory tests were performed to rule out infection when necessary.Results All patients were followed up for an average of 4.2 years(1-9 years).At the last follow-up,except for 1 patient who was bed-bound due to the sequela of cerebral infarction,the gait of the other patients was generally normal,and the lower limbs of all patients were nearly equal in length.The pain symptoms and joint dysfunction were significantly improved when compared with those before surgery,and there were no complications such as hip dislocation,prosthesis loosening and periprosthesis infection during follow-up.Compared with the preoperative results,the pain VAS score was significantly decreased at 1 year postoperative and the last follow-up,and the difference was statistically signifi-cant(F=279.879,P＜0.001),indicating that the patient's hip pain was significantly relieved.Compared with before surgery,the Harris score of hip function was significantly increased at 1 year post surgery and the last follow-up,and the difference was sta-tistically significant(F=269.628,P＜0.001),suggesting that the patient's hip function was significantly improved.At the last follow-up,the length discrepancy of lower limbs was(0.04±0.12)cm,which was significantly smaller than that before operation(1.12±0.28)cm,and the difference was statistically significant(t=27.849,P＜0.001).Conclusion The clinical efficacy of hip arthroplasty in the treatment of internal fixation failure after hip fracture surgery is good,and the postoperative pain symptoms and hip joint function are improved significantly.
Hip fractureHip arthroplastyRevisionInternal fixation failure
万方数据
维普
