Objective: To explore the key points in the treatment of hip pathological bony fused in non-functional position with total hip replacement, especially to find out the main reasons for improving the joint function and the patients' life quality before and after the operation. And to accumulate more experience for further clinical treatment.
Methods: From May 2001 to May 2005, 12 patients with hip bony fused in non-functional position were treated with total hip replacement. There were 5 males (ranging in age from 32 to 54 years,averaged 43.25 years) and 7 females (ranging in age from 29 to 64 years, averaged 48.80 years). The patients suffered from ankylosing spondylitis (AS, 5 patients), developmental dysplasia of the hip (DDH, 4 patients), and rheumatoid arthritis (RA, 3 patients). The course of the disease ranged from 5.25 to 20 years. All affected hips were bony fused,lost normal function and had rest pain. The X-ray showed there were no joint space left in the affected hips and trabecular bone crossed the femoral head to the acetabulum. The Harris evaluation system was performed before surgery, at 6, 12 and the 36 months after surgery.
Results: The Harris evaluation system showed the joint replacement surgery can significantly improve the patients' life quality. The postoperative scores of pain was (40.00 +/- 0.01), joint function was (31.53 +/- 5.36), range of motion was (1.94 +/- 0.05) and the deformity was (4.00 +/- 0.01), which had significantly difference (P < 0.05) from the scores of preoperative ones as the pain (1.18 +/- 3.32), joint function (0.01 +/- 0.01), range of motion (0.01 +/- 0.01) and the deformity (0.01 +/- 0.01). In the three year follow-up study,total scores had gradual improvement (P < 0.05)in the 6, 12 and the 36 months after the operation, which were (77.47 +/- 5.34), (80.95 +/- 4.01) and (82.90 +/- 3.39) respectively. The scores for limp, support, stairs,activities as wearing shoes or socks,and public transportation were (9.59 +/- 1.54), (8.88 +/- 2.69), (3.29 +/- 0.99), (3.75 +/- 0.66) and (6.01 +/- 0.01) respectively, and the former three, which were (10.47 +/- l.18), (10.06 +/- 1.75) and (3.76 +/- 0.66), had continually improved in 12 months after the operation (P < 0.05). Operation also solved the motion problem and made the joint remain stable. All the patients were recovered without complications of nerve injuries.
Conclusion: By the three year follow-up study, total hip replacement can significantly improve life quality of patients with hip pathological bony fused in non-functional position.