ABSTRACT
<p><b>OBJECTIVE</b>To investigate the preventive effects and differences of NSAIDs combined with radiotherapy, NSAIDs and radiotherapy for heterotopic ossification(HO) after total hip arthroplasty(THA).</p><p><b>METHODS</b>From February 2015 to July 2016, 168 hips undergoing primary THA were divided into group A, B and C, and 163 patients were followed up (54 cases and 54 hips in group A, 55 cases and 55 hips in group B, 54 cases and 54 hips in group C). Among group A, 5 hips were primary osteoarthritis, 37 hips were secondary osteoarthritis due to avascular necrosis of the femoral head, 12 hips were secondary osteoarthritis due to acetabular dysplasia. Patients in group A received oral celecoxib (0.2 g, 2 times a day) for 2 weeks after operation. Among group B, 6 hips were primary osteoarthritis, 32 hips were secondary osteoarthritis due to avascular necrosis of the femoral head, 17 hips were secondary osteoarthritis due to acetabular dysplasia, all of which in group B were treated with preoperative single 7 Gy radiotherapy. Among group C, 5 hips were primary osteoarthritis, 35 hips were secondary osteoarthritis due to avascular necrosis of the femoral head, 14 hips were secondary osteoarthritis due to acetabular dysplasia. Patients in group C were treated with preoperative radiotherapy and celecoxib after operation. The side effects of gastrointestinal reactions were observed after operation, and the heterotopic ossification was evaluated by pelvic anterior and posterior X-ray (Brooker grading).</p><p><b>RESULTS</b>The mean clinical and radiological follow-up was 21 months(12 to 30 months). In group A, 54 hips were followed up with 7 hips with heterotopic ossification, including 5 hips of Brooker I and 2 hips of Brooker II. In group B, 55 hips were successfully followed up, with 8 hips of heterotopic ossification occurred, including 6 hips of Brooker I, 2 hips of Brooker II. In group C, 54 hips were successfully followed up, with 5 hips of heterotopic ossification occurred , including 4 hips of Brooker I, 1 hip of Brooker II. There was no significant difference in efficacy among 3 groups (²=0.743, 0.690) by chi-square test. The prevalence of side effects were as following: in group A, there were 6 hips with side effects;in group B, there were 6 hips with side effects;in group C, there were 7 hips with side effects. There was also no significant difference in side effects among 3 groups (²=0.135, 0.935).</p><p><b>CONCLUSIONS</b>The combined-therapy group has lower prevalence of HO than the NSAIDs group or radiotherapy group, but the statistical difference between them is not significant. NSAIDs is still the first choice to prevent HO after THA.</p>
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between the risk of osteoporotic fracture in old people and the spinal morphology.</p><p><b>METHODS</b>From June 2010 to January 2011, 107 old people's BMD of femoral neck were measured by Dual energy X-ray. A questionnaire survey on fracture risk factors of the 107 aged and data collection were adopted. Among the aged,41 were male and 66 were female,ranging in age from 48 to 82 years old,with an averaged of (67 +/- 6) years old. The fracture risk assessment tools (FRAX) recommended by WHO were adopted. A risk assessment on osteoporotic fracture in old people was done,followed with the calculation of the probability of the hip fracture and the main bone fractures (spine,hip,forearm or shoulder fractures) in ten years. The angles of spine vertebra, spine curvature in the upright positions of the old people were measured by using Spinalmouse. The correlation analysis along with curve fitting analysis between the probability of fracture risk and included angles of spine vertebra, spine curvature were done.</p><p><b>RESULTS</b>The probability of osteoporotic fracture had a positive relation with thoracic vertebra T7 and T8, thoracic spine curvature,lumbar curvature and incline angle in upright position (P < 0.05).</p><p><b>CONCLUSION</b>The old people's morphological characteristics of spine have the ability to reflect the risk level o osteoporotic fracture.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Osteoporotic Fractures , Risk , Spinal Curvatures , Spinal FracturesABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical effects of total hip arthroplasty (THA) for Crowe type IV developmental dysplasia of the hip (DDH) and analyze perioperative complications.</p><p><b>METHODS</b>From March 2000 to March 2010, 19 patients (23 hips, of them, 4 patients with bilateral hips) with Crowe type IV DDH underwent THA. There were 5 males and 14 females, with average age of 61.3 years (ranged, 41 to 72 years). All hips were treated with small acetabular components combined with medial protrusion technique in acetabular reconstruction, as well as subtrochanteric shortening osteotomy in femur. Joint function of hips were evaluated according to Harris scoring.</p><p><b>RESULTS</b>All patients were followed up with an average of 4.2 years (ranged, 1 to 8 years). Postoperative X-ray films showed all acetabular prosthesis were in true acetabulum. No loosening and nonunion were found in all patients. Harris scoring improved from preoperative 34.0 +/- 6.9 to postoperative 85.0 +/- 7.5. Complications occurred in 11 cases in the patients, including femoral split fracture in 3 cases, nerve injury in 3 cases, delayed union in 2 cases, dislocation in 3 cases.</p><p><b>CONCLUSION</b>Total hip arthroplasty using small acetabular component, medial protrusion, femoral subtrochanteric shortening osteotomy technique for the Crowe type IV DDH can effectively restore hip function and leg length. But incidence of complications is high. The long-term follow-up is necessary for further study.</p>