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: Ankylosing spondylitis (ankylosing spondylitis, AS) is a chronic inflammatory disease, primarily affects the sacroiliac joints, spinal bony paraspinal soft tissue and peripheral joints, and can be associated with articular manifestations can occur in severe spinal deformity and tonic. AS occurred in young men, the male to female ratio of about 3: l have a significant incidence of familial tendency. Patients often occurs late hip completely stiff, this case can only be treated through surgery. Total hip arthroplasty (total hip arthroplasty, THA) has experienced more than a century of development, has become one of the classic surgical treatment of hip disease, relieve pain, improve joint function, restoring physical activity, etc., in the clinical a wide range of applications, is considered to be the most outstanding achievements of modern orthopedics. The young and the vast majority of ankylosing spondylitis patients, spine stiffness characteristics of the artificial joint have special needs, mainly in: joint friction interface to be able to withstand decades of wear and tear, to avoid the wear of product caused by bad reaction (osteolysis); while good postoperative hip activity, such patients often need to actively participate in the work and exercise. Therefore, their traditional hip replacement surgery presented a new challenge. With the development of materials science and metal tribology, 36mm diameter femoral head total hip arthroplasty and hip resurfacing surgery for these patients a better choice, two types of surgery increasingly attention. Then, two types of surgery has its own characteristics, whether that kind would be more suitable for patients with AS? Currently at home and abroad are still under active discussion, the subject of background research on the hot topic of the artificial joint surgery. Objective: comparison the 36mm diameter femoral head total hip arthroplasty and hip resurfacing arthroplasty of clinical and radiological results to assess the two types of surgery which is more suitable for younger patients with ankylosing spondylitis. Subjects and methods: 1, object of study: the period from August 2008 to August 2010, our hospital on 16 patients (21 hips) diagnosed with ankylosing spondylitis patients with a 36mm diameter femoral head total hip arthroplasty. There were 11 males and 5 females, average age of 29.2 years (19 to 42 years old), average body mass index of 23.2 (18.1 to 26.7). The same period, 11 patients (12 hips) diagnosed with ankylosing spondylitis patients in our hospital hip resurfacing arthroplasty. Including 8 males and 3 females, with an average age of 28.8 years (20 to 31 years old), average body mass index of 22.9 (17.7 to 26.6). The patients in both groups there was no significant difference in gender, age and body mass index. 2: 36mm diameter femoral head total hip arthroplasty and hip resurfacing arthroplasty patients clinical (intraoperative and postoperative) and radiographic parameters within the group and between groups, analysis of two prosthetic systems advantages and disadvantages. Observation methods and indicators: record groups during the follow-up of patients with postoperative deep vein thrombosis incidence rate of postoperative dislocation and infection, as well as surgical time, blood loss, incision length, and assess the two groups of patients, respectively Harris hip score, the evaluation of patients with postoperative recovery of joint function; hip pelvis standard anteroposterior film and the hip lateral radiographs evaluation based on the follow-up period activity degrees (ROM), visits prosthesis implantation and survival. 4, statistical methods: group variables by paired t-test compared the variables between the groups were compared by independent t test, using the SPSS 13.0 software for statistical analysis, P lt; 0.05 was considered significant difference. Results: Both groups received a satisfactory clinical outcome, there is significant improvement in the Harris hip score in patients compared with preoperative. The two groups of patients the incidence of postoperative hip joint dislocation, there were no significant differences in postoperative infection rate, incidence of deep venous thrombosis and postoperative hip activity. 36mm diameter femoral head total hip patients in the operative time, incision length comparison better than the hip resurfacing group, the difference was significant. Resurfacing on the comparison of the blood loss than 36mm diameter femoral head total hip group, the difference was significant. Imaging observations suggest that the prosthesis bone ingrowth, translucent with no obvious radioactive. 36mm diameter femoral head total hip replacement group 2 hips (9.5%) Brooker Ⅰ heterotopic ossification, the resurfacing group 1 hip (8.3%) were observed Brooker Ⅰ heterotopic ossification. Conclusion: 1,36 mm diameter femoral head total hip arthroplasty and hip resurfacing arthroplasty able to obtain satisfactory clinical results; 2, no significant differences in the incidence of postoperative dislocation, infection and hip activity; 3,36 mm diameter femoral head total hip arthroplasty in operative time, incision length has a better advantage.
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