[Intraoperative imaging to monitor prosthetic fixation for total hip arthroplasty]

To explore the intraoperative imaging to monitor the prosthetic fixation for the total hip arthroplasty (THA) and to increase the accuracy of the primary THA prosthetic fixation.

From April 2000 to August 2005, 69 patients (75 hips) underwent THA monitored by the imaging (the imaged THA group, Group I), and 72 patients (78 hips) underwent THA with the standard method (the standard THA group, Group S). There were 32 72 patients (78 hips) underwent THA with the standard method (the standard THA group s in Group S). There were 32 males and 37 females in Group S. The mean ages of the patients in Group I and Group S were 62. 3 years and 60. 5 years respectively, ranging 46-75 years in Group I and 43-75 years in Group S. Preoperative diagnoses were femoral neck fractal measure (Garden III, IV ) in 23 patients (23 hips) in Group and 2 5 patients (25 hips) in Group S, acetabular dysplasia Campbell I , II) in 9 patients (10 hips) in Group I and 11 patients (13 hips) in Group S osteoarthritis in 16 patients (17 hips) in Group I and 15 patients (15 hips) in Group S, femoral head osteonecrosis (Ficat III, IV ) 15 patients (16 hips) in Group I and 17 patients (17 hips) in Group S, and rheumatoid arthritis in 6 patients (9 hips) in Group I and 4 patients (8 hips) in Group S. There were 21 hips of cement prostheses in Group I and 22 hips in Group ferative 12 hips of cementless prostheses in Group I and 11 hips in Group S, 42 hips of cement and cementless prostheses in Group I and 45 hips in Group S. Group I used the standard THA and the intraoperative X-ray monitoring the prosthetic fixation in the numerical measure of abduction angle, anteversion angle, femoral neck length, and femoral offset distance. The items compared between Group I and Group S included incisional length, intraoperative bleeding, transfusion, operative time, frequency of X-ray imaging, infection, postoperative functional recovery, and prosthetic position of postoperative X-ray imaging. RESULTS The follow-up on 62 patients in Group I and 64 patients in Group S for 6-64 months averaged 42 months revealed that there were statistically significant differences in incisional length, intraoperative bleeding. transfusion, operative time, frequency of X-ray imaging, postoperative functional recovery, prosthetic position of postoperative X-ray imaging, and the Harris score between Group I and Group S one year after operation. The results of Group I were significatnly better than those of Group S.

The intraoperative X-ray imaging can increase the accuracy of the THA prosthetic fixation and reduce the incidence of THA maloperation by The X-ray imaging can also be used in county hospitals if C-arm fluoroscopy can be provided.