RÉSUMÉ
Objective To explore the effect and influencing factors of prosthesis placement angle on hip replacement for bone fusion of hip joint.Methods A total of 100 patients with bone fusion of hip joint who were admitted to our hospital from May 2019 to January 2022 were selected as the research objects and randomly divided into the observation group(n=50)and the control group(n=50).The prosthesis placement angle was 30° to 40° in the observation group and 41° to 50° in the control group.The clinical data,VAS score and Harris score before and after operation,and postoperative complications of the two groups were compared.The improvement of hip joint function of the two groups was compared by random walking model.According to the prognosis of patients,patients were divided into the poor prognosis group(n=32)and the good prognosis group(n=68).Univariate and multivariate Logistic regression analysis were used to analyze the independent influencing factors of the prognosis of hip replacement for bone fusion of hip joint,and a prediction model was constructed and verified.Results The Harris score 6 months after operation in the observation group was significantly higher than that in the control group(P<0.05),and there was no significant difference in VAS score before and after operation and incidence of complications after operation between the two groups(P>0.05).The results of random walking model showed that the improvement of hip joint function in the observation group was better than that in the control group.There were significant differences in age,hyperlipidemia,osteoporosis,prosthesis placement angle,intraoperative blood loss,emotional disorder,postoperative complications,rehabilitation training and postoperative outdoor activity time of patients between the good prognosis group and the poor prognosis group(P<0.05).Multivariate Logistic regression analysis showed that osteoporosis and prosthesis placement angle of 41° to 50° were the independent risk factors of the prognosis of hip replacement for bone fusion of hip joint(P<0.05),and rehabilitation training was the protective factor(P<0.05).A prediction model of the prognosis of hip replacement for bone fusion of hip joint was constructed.The calibration curve of the model fit well with the ideal curve,and the area under the receiver operating characteristic curve(AUC)was 0.854(95%CI:0.830 to 0.871),which indicates that the prediction model had good accuracy.The concordance index(C-index)of the model was 0.849(95%CI:0.817 to 0.868),which indicates that the model had high discrimination.Conclusion The prosthesis placement angle of 30° to 40° can significantly improve the postoperative hip joint function of patients,and the therapeutic effect is significant.Osteoporosis,prosthesis placement angle,and rehabilitation training are the independent influencing factors of the prognosis of hip replacement for bone fusion of hip joint.
RÉSUMÉ
BACKGROUND: Investigation on epidemiologic features of knee osteoarthritis in many areas of China has been much reported. However, multicenter studies with large samples have been rarely reported. The published papers cannot give a good description about the epidemiologic features of knee osteoarthritis. OBJECTIVE: To evaluate the epidemiologic features of knee osteoarthritis in the patients aged over 40 years in China. METHODS: Meta-analysis was used to evaluate the data extracted from papers published 2001-2016 on the epidemiology of knee osteoarthritis in the middle-aged and elderly in China. The prevalence rate of knee osteoarthritis in the patients over 40 years of age was summarized, with every 10 years as group, and then analyzed on Stata 12.0 software. RESULTS AND CONCLUSION: Twenty-six articles were included, involving 42 199 people aged more than 40 years old. The total prevalence rate of knee osteoarthritis at the age above 40 years old in China was 17.0% (95% CI:16.7%-17.4%),the prevalence rate was 12.3% in male and 22.2% in female(P<0.05).Noticeably,the prevalence rate increased with age.The total prevalence rate in northern China was 16.1%(95% CI:15.6%-16.6%),12.2% in male and 21.4% in female;the total prevalence in southern China was 18.0%(95%CI:17.5%-18.5%), 12.3% in male and 23.1% in female. There was no significant difference in the prevalence rate between northern and southern China(P>0.05).The total prevalence rate in rural China was 23.6%(95%CI:16.7%-30.4%),with 15.4% in male and 28.1% in female;and the total prevalence in urban China was 20.0%(95% CI:16.2%-23.9%),with 13.7% in male and 24.3% in female. There was no significant difference in the prevalence rate between rural and urban China (P > 0.05). These results suggest that knee osteoarthritis in China is a common disease, characterized by increased prevalence with age, relatively significant difference between male and female, but no difference between northern and southern China as well as between rural and urban China. It is of great significance to timely propagate and perform interventional strategies for prevention and treatment of knee osteoarthritis in China.