RESUMO
OBJECTIVE: To explore the clinical efficacy of high hip center technique total hip arthroplasty ï¼THAï¼ for Crowe â ¡and â ¢ developmental dysplasia of hip ï¼DDHï¼ and severe hip osteoarthritis ï¼HOAï¼. METHODS: From January 2018 to January 2020, 74 patients with Crowe typeâ ¡and â ¢ DDH and severe HOA were admitted, and 37 cases of anatomical hip center reconstruction were taken as control group, including 7 males and 30 females, aged from 42 to 65 years old with an average of ï¼58.40±4.98ï¼ years old, body mass index ï¼BMIï¼ ranged from 18 to 29 kg·m-2 with an average of ï¼23.02±2.21ï¼ kg·m-2. Thirty-seven routine high hip center technical reconstruction were performed as study group, including 5 males and 32 females, aged from 41 to 65 years old with an average of ï¼57.31±5.42ï¼ years old, BMI ranged from 18 to 29 kg·m-2 with an average of ï¼23.14±2.07ï¼ kg·m-2. The patients presented with hip pain, limited function and range of motion, and gait instability before surgery. All patients underwent THA, the control group underwent intraoperative anatomical hip center reconstruction, and the study group underwent intraoperative high hip joint reconstruction. The perioperative indicators of the two groups were compared. The hip joint function, balance function and gait of the patients were evaluated before surgery, 3 months, 6 months, and 12 months after surgery. The length difference of both lower limbs, horizontal distance of rotation center, vertical distance of rotation center and femoral eccentricity were measured before operation and 1 year after operation. The incidence of complications in the two groups during the operation and postoperative follow-up was counted. RESULTS: The operation time of the study group was shorter than that of the control group, and the intraoperative blood loss was less than that of the control group ï¼P<0.05ï¼. After 12-months follow-up, 1 was lost to followvup in study group and 2 were lost to follow-up in control group. The Harris scores and Berg balance scaleï¼BBSï¼, pace, stride frequency and single step length in the study group were higher than those in the control group at 3 months and 6 months after operation ï¼P<0.05ï¼ï¼there was no statistically significant difference between the two groups in the indexes 12 months after operation ï¼P>0.05ï¼. The vertical distance of the center of rotation of the study group was greater than that of the control group 12 months after operation ï¼P<0.05ï¼, and there was no significant difference in the length difference of the lower limbs, the horizontal distance of the center of rotation, and the femoral eccentricity between two groups ï¼P>0.05ï¼. There were no complications in either group. CONCLUSION: The long-term effects of THA in patients with DDH and severe HOA were similar between the two central hip reconstruction methods, and the safety was good, and the high hip central reconstruction technique could shorten the operation time and reduce the amount of intraoperative blood loss.At the same time, it has certain advantages in early recovery of hip joint function, balance function and walking function of patients.