Characteristics of total hip arthroplasty in patients with end stage renal disease

doi:10.3969/j.issn.2095-4344.2013.26.002

Abstract

Abstract:

BACKGROUND: Due to the long-term bone metabolism, endocrine disorders and the application of hormones, the end stage renal disease is prone to femoral neck fractures, femoral head avascular necrosis and other diseases. The patients with end stage renal disease have the characteristics that different to general hip joint replacement when having total hip arthroplasty.
OBJECTIVE: To observe the characteristics of biological or cementless total hip arthroplasty for the treatment of end stage renal disease combined with hip diseases.
METHODS: The clinical data of 15 end stage renal disease patients with hip disease (four males and 11 females) who received total hip arthroplasty or artificial femoral head replacement in the Third Affiliated Hospital of Sun Yat-sen University from June 2006 to March 2012 were retrospectively reviewed. There were eight cases of femoral neck fracture (one case of bilateral femoral neck fracture), five cases of femoral head avascular necrosis, two cases of osteoarthritis, totally 16 hips. The joint replacement included total hip arthroplasty in nine hips (cementless type five hips, cemented type four hips) and hemiarthroplasty in seven hips (cementless type two hips, cemented type five hips). The follow-up X-ray film was taken to observe whether the translucent zone could be seen around the prosthesis, as well as the dynamic changes, and the Harris hip score and SF-36 score were used to evaluate the recovery of joint function and improvement of life quality.
RESULTS AND CONCLUSION: Patients were followed-up for 0.5-4 years after replacement, the followed-up time showed skewed distribution, and the median time was 30 months. Harris hip score was increased from preoperative (53.0±5.8) to the last follow-up (86.0±3.8). SF-36 score was increased from preoperative (65.0±2.4) to the last follow-up (83.0±4.9). There were five cases of complications before discharge, two cases of hypotension shock when undergoing dialysis after replacement, two cases of pulmonary infection, one case of delayed wound union, and all the patients recovered after treatment. No prosthesis loosening, dislocation or prosthesis infection was observed during follow-up after replacement. The early to medium-term follow-up results show that total hip arthroplasty can relieve pain and improve hip function and life quality during the treatment of end stage renal disease patients with hip diseases. Some patients do not have good postoperative follow-up results due to the progress of kidney disease.

Key words: bone and joint implants, artificial prosthesis, end stage renal disease, femoral neck fracture, osteoarthritis, avascular necrosis, total hip arthroplasty

CLC Number:

R318

Zhuang Ze, Li Zhi-yong, Chen Yu-xian, Ren Jian-hua, He Rong-han, Zhao Jia-yao, Wang Kun. Characteristics of total hip arthroplasty in patients with end stage renal disease[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.26.002.

Figures/Tables 5

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