A Prospective Randomized Controlled Trial Assessing the Impact of Preoperative Combined with Postoperative Progressive Resistance Training on Muscle Strength, Gait, Balance and Function in Patients Undergoing Total Hip Arthroplasty.

Purpose: The aim of this study is to investigate the effects of a preoperative combined with postoperative moderate-intensity progressive resistance training (PRT) of the operative side in patients with hip osteoarthritis (HOA) who are undergoing total hip arthroplasty (THA). The study seeks to evaluate the impact of this combined intervention on muscle strength, gait, balance, and hip joint function in a controlled, measurable, and objective manner. Additionally, the study aims to compare the outcomes of this combined intervention with those of preoperative or postoperative muscle strength training conducted in isolation. Methods: A total of 90 patients with HOA scheduled for unilateral primary THA were randomly assigned to three groups: Pre group (preoperative PRT), Post group (postoperative PRT), and Pre& Post group (preoperative combined with postoperative PRT) focusing on hip flexion, extension, adduction, and abduction of operated side. Muscle strength, gait parameters, balance, and hip function were assessed at specific time points during a 12-month follow-up period. Results: All three groups showed significant improvements in muscle strength, with the Pre& Post group demonstrating the most pronounced and sustained gains. Gait velocity and cadence were significantly improved in the Pre& Post group at 1-month and 3-month postoperative follow-ups compared to the other groups. Similarly, the Pre& Post group exhibited superior balance performance at 3-month and 12-month postoperative follow-ups. The Harris Hip Score also showed better outcomes in the Pre& Post group at all follow-up intervals. Conclusion: Preoperative combined with postoperative moderate-intensity PRT in HOA patients undergoing THA led to superior improvements in muscle strength, gait, balance, and hip joint function compared to preoperative or postoperative PRT alone. This intervention shows significant promise in optimizing postoperative rehabilitation and enhancing patient outcomes following THA.

[Applied research on autologous bone graft for acetabular defect of Crowetype III and IV hip dysplasia].

OBJECTIVE: To study clinical efficacy of autologous bone graft for acetabular defect of Crowe III and IV hip dysplasia. METHODS: The 22 patients with 25 hips of DDH (Crowe type III, IV) from March 2010 to May 2013 were retrospectively analyzed. Total hip arthroplasty (THA) combined autogenous bone grafting was performed for all these patients with osteoarthritis secondary to DDH. Among them, 19 patients were females (21 hips) and 3 patients were males (4 hips), ranging in age from 43 to 67 years old, averaged 55 years old. There were 6 hips with Crowe type III and 19 hips with Crowe type IV. Before surgery, all the patients had hip pain, limb shortening and hip limited function of hip joint. After 12 months, the degree of recovery about limb length, functional recovery, autogenous bone graft fusion were observed. RESULTS: All the patients were followed up and no dislocation were occurred. At 12 months after operation, the average Harris hip joint llzncation score were 83.30±6.13, and 18 cases got an excellent result and 4 good. The length of lower limbs decreased from preoperative (3.20±0.81) cm to 12 months after operation (0.92±0.23) cm (t=14.864, P<0.05). CONCLUSION: THA combined with structural femoral head autograft for patients with osteoarthritis secondary to DDH can obtain favorable results, significantly improving the effect of operation treatment.

[Renovation stem revision femoral head arthroplasty for unstable intertrochanteric fracture in the elderly].

OBJECTIVE: To observe clinical efficacy of renovation stem revision femoral head arthroplasty for the treatment of unstable intertrochanteric fracture in the elderly. METHODS: Totally 32 elderly patients with unstable intertrochanteric fracture were treated with renovation stem revision femoral head arthroplasty from September 2007 to January 2011. There were 11 males and 21 females with an average age of 83.8 (ranged, 80 to 98) years old,the time from injury to hospital ranged from 4 h to 14 days. According to Evans-Jensen classification, 6 cases were type II a, 20 cases were type II b, and 6 cases were type III. Postoperative mortality, complication rates and Harris hip function score were compared and analyzed to evaluate curative effect. RESULTS: All patients were followed up and no dislocation occurred. Six patients were died during 15 months and 4.5 years; 24 cases recoved to independent wakling at 6 months after operation, and 8 cases walked with stick and walker. The average Harris hip joint function score were (91.56 +/- 2.96), 28 cases got excellent results and 4 cases good. Nine cases occurred complications and healed after treatment. CONCLUSION: Renovation stem revision femoral head arthroplasty is a active and reliable method in treating unstable intertrochanteric fracture in the elderly.