Effectiveness of Total Hip Arthroplasty Combined With Hip Braces for Hip Charcot Arthropathy.

IF 1.8 2区 医学 Q2 ORTHOPEDICS Orthopaedic Surgery Pub Date : 2024-12-23 DOI:10.1111/os.14329
Long-Teng Chao, Teng-Feng Zhuang, Song-Wei Huan, Si-Min Luo, Chong-Jie Wu, Wen-Rui Wu, Zhen-Gang Zha, Huan-Tian Zhang, Ning Liu
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Abstract

Objective: Charcot arthropathy is characterized by varying degrees of sensory loss and rapidly progressive joint destruction. Historically, limited studies indicated that Charcot arthropathy of the hip joint may be a contraindication for total hip arthroplasty (THA). Yet, some recent studies have shown that good clinical results and acceptable survival rate. Hence, this study aimed to investigate clinical outcomes, radiographic outcomes, complication rates and survivorship of primary THA in Charcot arthropathy.

Methods: We retrospectively included 11 patients (11 hips) with Charcot arthropathy who underwent THA between 1998 and 2016. All involved patients were diagnosed as syphilis. All patients had classic radiographic findings of Charcot arthropathy. The hip braces were used in all patients for six weeks after surgery. Outcome measures included VAS, Oxford Hip Score, and UCLA score. Statistical analyses involved t-tests, chi-square tests, and Kaplan-Meier survival analysis.

Results: The average follow-up period was 81.73 months. The average VAS, Oxford Hip Score, and UCLA score were improved significantly. There was higher complication rate of 45.5% after THA. Reoperation was carried out in two patients due to dislocation and acetabular component loosening. The Kaplan-Meier survivorship with an end point of reoperation for any reason was 81.8%.

Conclusions: THA is proved to be reasonable in improving hip joint function, which is suitable for patients with Charcot hip joint. Although the complication rate is high, we consider that THA combined with hip brace may be a valid treatment choice for Charcot arthropathy with detailed preoperative planning and proper precautions.

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全髋关节置换术联合髋关节支架治疗髋关节沙化关节病的疗效观察。
目的:Charcot关节病以不同程度的感觉丧失和快速进行性关节破坏为特征。历史上,有限的研究表明,髋关节的Charcot关节病可能是全髋关节置换术(THA)的禁忌症。然而,最近的一些研究显示了良好的临床效果和可接受的存活率。因此,本研究旨在探讨Charcot关节病原发性THA的临床结果、影像学结果、并发症发生率和生存率。方法:我们回顾性地纳入了1998年至2016年间11例(11髋)Charcot关节病患者。所有患者均被诊断为梅毒。所有患者均有沙科关节病的典型影像学表现。所有患者术后6周均使用髋关节支架。结果测量包括VAS评分、牛津髋关节评分和UCLA评分。统计分析包括t检验、卡方检验和Kaplan-Meier生存分析。结果:平均随访81.73个月。平均VAS评分、牛津髋部评分和UCLA评分均有显著改善。THA术后并发症发生率为45.5%。2例患者因脱位和髋臼部件松动而再次手术。以任何原因为再手术终点的Kaplan-Meier生存率为81.8%。结论:THA在改善髋关节功能方面是合理的,适用于Charcot髋关节患者。虽然并发症发生率高,但我们认为THA联合髋关节支具可能是治疗Charcot关节病的有效选择,只要有详细的术前计划和适当的预防措施。
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来源期刊
Orthopaedic Surgery
Orthopaedic Surgery ORTHOPEDICS-
CiteScore
3.40
自引率
14.30%
发文量
374
审稿时长
20 weeks
期刊介绍: Orthopaedic Surgery (OS) is the official journal of the Chinese Orthopaedic Association, focusing on all aspects of orthopaedic technique and surgery. The journal publishes peer-reviewed articles in the following categories: Original Articles, Clinical Articles, Review Articles, Guidelines, Editorials, Commentaries, Surgical Techniques, Case Reports and Meeting Reports.
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