Etiology and factors of total hip replacement in Hefei area of China: retrospective analysis on 3 056 cases from 5 hospitals in 6 years

doi:10.3969/j.issn.2095-4344.2015.09.007

Abstract

Abstract:

BACKGROUND: The etiologies of total hip replacement are complex, such as femoral neck fracture, avascular necrosis of the femoral head, primary osteoarthritis, congenital hip dysplasia, rheumatoid arthritis, ankylosing spondylitis, traumatic arthritis and infectious arthritis. Due to different causes and epidemiological characteristics of these diseases, they occupy different percentages in total hip replacement.
OBJECTIVE: To analyze the etiological composition of patients in Hefei area undergoing total hip replacement and the distribution in ages and genders, in a broader attempt to improve the early screening and prevention of hip diseases and susceptible factors.
METHODS: A retrospective study was performed in 3 056 patients receiving total hip replacement in five hospitals in Hefei area from January 2008 to December 2013. These patients were divided into 11 groups according to discharge diagnosis, and the constituent ratio of ages and genders was analyzed.
RESULTS AND CONCLUSION: Among the involved 3 056 patients, 1 763 patients had hip fracture (56.78%), 545 avascular necrosis of femoral head (17.55%), 461 primary osteoarthritis (14.85%), 196 developmental dysplasia of hip (6.31%), 35 rheumatoid arthritis (1.13%), 10 ankylosing spondylitis (0.32%), 26 traumatic arthritis (0.84%),12 infective arthritis (0.39%), 4 tumor of hip (0.13%), 3 fibrous dysplasia of bone (0.097%), and 1 Kaschin Beck disease (0.032%). The proportion of patients over 50 years old was obviously higher than that of the patients under age of 50 years (including 50 years; χ²= 12.7, P < 0.05). The proportion of female patients was higher than that of male patients (χ²=61.07, P < 0.05). The results showed that the etiologies of the patients receiving total hip replacement in five hospitals in Hefei area are complex, the major causes include hip fracture, avascular necrosis of femoral head and primary osteoarthritis, the main patients are over 50 years old, and the proportions of female patients is higher than that of the male patients.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: Arthroplasty, Replacement, Hip, Hip, Fractures, Bone, Femur Head Necrosis, Arthritis

CLC Number:

R318

Ma Zhi-xiang, Yin Zong-sheng, Xu Peng-fei, Gao Wei-lu, Hu Qin, Qi Jia-long. Etiology and factors of total hip replacement in Hefei area of China: retrospective analysis on 3 056 cases from 5 hospitals in 6 years[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(9): 1352-1357.

Figures/Tables 1

2.1 参与者数量分析本次研究中共入选3 674例患者，按照国际疾病分类标准编码ICD-10分成11组。根据排除标准，排除非合肥市人口403例，排除因同一病因行对侧手术174例，排除髋关节翻修手术41例，共排除618例，共有3 056例患者录入研究。 2.2 不同年份人数比较 2008年行人工髋关节置换390 例，2009年384例，2010年424例，2011年501例，2012年607例，2013年750例，见图1。 2.3 病因构成在3 056例病例中，髋部骨折第1位，共1 763例(其中股骨颈骨折患者1 610例、股骨转子区骨折患者153例，56.78%)；股骨头缺血性坏死第2位，共545例(17.55%)；原发性骨关节炎第3位，共461例(14.85%)；继发性髋关节炎包括：先天性髋关节发育不良、类风湿关节炎、强直性脊柱炎、创伤性关节炎、感染性关节炎等，比例远低于原发性关节炎，共计279例(9.13%)。髋部肿瘤4例(0.13%)，骨纤维性发育不良3例(0.097%)，大骨节病1例(0.032%)所占比例极低，见表1。 2.4 年龄构成在3 056例病例中，年龄最大的107岁，年龄最小的 19 岁，平均年龄(66.26±13.30) 岁。7个年龄组中以71-80岁组人数最多，846例，占27.72%；随着年龄的增大，人数逐渐增多，但大于80岁以上年龄组人数(共438例，占14.33%)少于51-80各组人数，但差异无显著性意义 (χ2=1.52，P > 0.05)。50岁以上患者所占比例显著大于50岁以下(包括50岁)患者所占比例(χ2=12.7，P < 0.05)，见表2。 2.5 性别构成在3 056例病例中，男共1 312例，占 42.93%；女共1 744例，占57.07%，女性患者所占比例高于男性，差异有显著性意义(χ2=61.07 ，P < 0.05)。髋部骨折患者中，男691例(22.61%)，女1 072例(35.08%)，女性患者所占比例明显高于男性，差异有显著意义(χ2=82.34，P < 0.05)；股骨头缺血性坏死患者中，男336例(10.99%)，女209例(6.84%)，女性患者所占比例显著低于男性，差异有显著性意义(χ2=29.59，P < 0.05)。原发性关节炎患者中，男201例(6.58%)，女260例(8.51%)，女性患者所占比例高于男性，差异有显著性意义(χ2=7.55，P < 0.05)，见表3。"

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