RESUMEN
Fifty-eight primary total hip arthroplasties with hyhrid cemented femoral component using contemporary cementing technique and cementless acctahular cup were followed for a minimum 3 year(ranged, 36 to 67 months, mean 4.1 years). Thc average age of the patients at the time of the operation was 54 years(ranged, 22 to 73 years). The preoperative common diagnosis were avascular necrosis of femoral head in 38 hips and miscellaneou. in 20 hips. The mean Harris hip score was 61 in preoperative and 91 in postoperative at last Follow-up. 5-1 hips(92%) were rated excellent and good clinically. One hip was revised for aseptic loosening of the femoral stem at 52 months follow-up. Radiographically no acetahular component was loose. Three femoral stems were definitely loose, one stem was classfied as prohahle loosenine and another one was ratde as possible loosening. There was no progressive radiolucent dermaation ol' cement-hone interf'ace in stable fermoral steni. Non progressive cement-bone radiolucency was lound seven hips in zone 1, two hips in zone 6, one hip in zone 2 and one hip in zone 7 at last follow-up. There were two postoperalive dislocations. Other complications included superficial infection(two hips) and sciatic nervc palsy(one hip). Our experience showed that the hyhrid hip replaccment with improved cementing technique provided satisfactory results at minimum 3 year follow-up study and emphasized the importantance of careful cementing techniques in survival ot cemented I'cmoral stem.
Asunto(s)
Humanos , Artroplastia , Artroplastia de Reemplazo de Cadera , Diagnóstico , Luxaciones Articulares , Dronabinol , Estudios de Seguimiento , Cabeza , Cadera , NecrosisRESUMEN
The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Asunto(s)
Anciano , Femenino , Humanos , Actividades Cotidianas , Libertad , Fracturas de Cadera , Cadera , Memoria , Ortopedia , Calidad de Vida , Rango del Movimiento ArticularRESUMEN
Prediction of acetabular development after reduction in treatment of developmental dysplasia of thc hip (DDH) is earlier, the hetter results because it would help ensure optimal timing of additional procedure if necessary. In this respect, authors reviewed retrospectively the radiographs of the hips of 35 children with DDH who had unilateral involvement and treated hy senior author (S.H.Lee) from the heginning with single successful attempt of reduction. The radiographs which were made at the time of initial diagnosis, one, two year nfter reduction und final follow up were assessed of teardrop figures. The results of treatment were classified as satisfactory group(CE > 10degrees ) and unsatisfactory group(CE < 10degrees) judged hy center-edge angle(CE degrees) at final follow-ups. 1. The teardrop figures were classifiable into 4 distinct groups as i)absent. ii)V-shaped, iii)Ushaped, iv) inverted D-shaped. 2. The teardrop figures in normal sides of hip were all U-shaped. 3. In dislocated but with satisfactory result group(24 cases), absent at 2 cases(8%), U-shaped teardrop was seen at 13 cases(54%), V-shaped in 9 cases(38%), and inverted 2-shaped in 0 case at I year after reduction. 4. In dislocated but with unsatisfactory result group( 11 cases), they were mostly of V-shaped(7 cases, 64%). The rest were of ahsent in 4 cases(36%) . hut none of U-shaped and inverted 2-shaped. In conclusions, teardrop figures appeared as significant predictor of future development of hip joint. Teardrop figure which stay as V-shaped at one year after reduction seems suggestive of insufficient reduction of DDH, therehy calls for early additional procedure.