Why do Hong Kong patients need total hip arthroplasty? An analysis of 512 hips from 1998 to 2010

Abstract

Introduction: The number of patients undergoing total hip replacement surgeries has increased as a result of a rise in the ageing population. This study reviewed the demographics and disease spectrum leading to primary total hip replacement in the Chinese population from 1998 to 2010.

Methods: This case series was conducted in a university teaching hospital in Hong Kong. Data from the prospective joint registry of all patients who underwent primary total hip replacement from January 1998 to December 2010 were reviewed. Patients’ age and sex, diagnosis, as well as the Harris Hip Scores before operation and at the last follow-up were described.

Results: There were 512 primary total hip replacements performed on 419 patients (43.4% males) during the study period. All had clinical follow-up for at least 2 years. The mean age of the patients was 57.6 (standard deviation, 16.6) years. In males, the main aetiology was osteonecrosis (50.9%), ankylosing spondylitis (19.5%), and post-traumatic arthritis (8.5%). For females, it was osteonecrosis (33.0%), primary osteoarthritis (18.8%), and post-traumatic arthritis (15.8%). Alcohol-induced (52.5%) and idiopathic (40.7%) was the most common cause of osteonecrosis in males and females, respectively. The mean preoperative Harris Hip Score and that at last follow-up was 43.9 (standard deviation, 18.3) and 89.7 (standard deviation, 13.0), respectively.

Conclusions: Osteonecrosis was the most common aetiology leading to total hip replacement although there were different causes in both sexes leading to it. The clinical result in terms of Harris Hip Score was good for all patients who required total hip replacement.

引言：隨着人口老化，每年置換髖關節的人數也越來越多。本研究分析由1998年至2010年期間首次接受髖關節置換手術病人的數據和疾病模式。 方法：本病例系列分析香港一所大學教學醫院內的資料，搜集1998年1月至2010年12月期間首次接受髖關節置換手術病人的數據，包括其年齡、性別、診斷結果、手術前和最後一次隨訪評估的Harris髖關節評分量表。 結果：研究期間共有419位患者首次接受了512次髖關節置換手術，當中男性佔43.4%。這些患者最少有兩年隨訪期。他們平均57.6歲（標準差16.6歲）。至於接受相關手術的主要原因，男性患者主要為缺血性壞死（50.9%）、強直性關節炎（19.5%）和創傷後關節炎8.5%）；女性患者主要為缺血性壞死（33.0%）、原發性骨關節炎（18.8%）和創傷後關節炎（15.8%）。酒精引發的缺血性壞死是在男性患者中最常見的成因（52.5%）；而突發性缺血性壞死則是女性患者中最常見的成因（40.7%）。手術前和最後一次隨訪評估的Harris髖關節評分量表之平均得分分別為43.9（標準差18.3）和89.7（標準差13.0）。 結論：雖然導致男性和女性患者缺血性壞死的成因各有不同，但缺血性壞死仍是導致全髖關節置換手術的最常見原因。此外，Harris髖關節評分量表中的得分反映曾接受過全髖關節置換手術患者的臨床結果良好。