Short-term clinical effect of total hip replacement in the treatment of sequelae of septic arthritis of the hip: A retrospective study

Abstract

Total hip arthroplasty in the treatment of sequelae of suppurative hip arthritis is very complicated. To observe the short-term efficacy and complications of total hip arthroplasty in the treatment of sequelae of suppurative hip arthritis and to improve the success rate and curative effect of operation, the clinical data of 32 patients with sequelae of suppurative hip arthritis who underwent total hip arthroplasty in our department from June 2013 to December 2020 were retrospectively analyzed. The age of hip suppurative infection was 2 to 17 years, with an average age of (9.8 ± 6.2) years. The average age was (35.2 ± 12.5) years. All the patients were treated by the direct lateral approach (Hardinge approach), and the acetabular and femoral sides were fixed with the biological prosthesis. All the 32 patients were followed up, and 2 patients had sciatic nerve palsy after operation, and the neurological symptoms recovered after conservative treatment for 1 month. One case of subtrochanteric osteotomy nonunion and femoral prosthesis loosening was treated with femoral lengthening stem revision. The clinical symptoms and hip joint activity of all patients were significantly improved after operation. The average Harris score was 43.3 ± 7.2 before operation and 88.6 ± 9.1 at the last follow-up after operation, and the difference was statistically significant (P < .05). The preoperative visual analogue scale was (7.1 ± 1.6) points, and it decreased to (1.1 ± 0.6) points at the last follow-up, and the difference was statistically significant (P < .05). Total hip arthroplasty in the treatment of sequelae of suppurative hip arthritis has a satisfactory short-term effect, which can effectively relieve pain and improve hip joint function after operation.

Keywords: clinical outcomes; sequelae; suppurative hip arthritis; total hip arthroplasty.

Figure 1.

(A) Preoperative photos showed multiple wounds and sinus scars. (B) Preoperative radiographs showing missing left femoral head. (C) Postoperative radiographs, subtrochanteric osteotomy. (D) Radiographs 1 year after surgery showed that the osteotomy had healed.