Effect of Operation Room Nursing Intervention and Ceramic Prosthesis on Total Hip Arthroplasty

In order to solve the problems of large trauma, many postoperative complications, and complex operation of artificial hip arthroplasty, a method to analyze the application effect of operating room nursing intervention in artificial hip arthroplasty was proposed. Firstly, 120 patients who underwent hip arthroplasty in our hospital from January to December 2017 were selected; Secondly, they were randomly divided into routine group (60 cases) and intervention group (60 cases); finally, on this basis, the intervention group strengthened the nursing in the operating room and used nanoceramic prosthesis. The Harris score of hip joint, the incidence of postoperative complications, and the satisfaction with nursing services were compared between the two groups. The results showed that the Harris score of hip joint and the satisfaction score of nursing service in the intervention group were significantly higher than those in the routine group (P < 0.05); the incidence of postoperative complications in the intervention group was significantly lower than that in the routine group (P < 0.05). It is proved that actively carrying out nursing intervention in the operating room and using nanoceramic prosthesis can not only improve the clinical efficacy and nursing service satisfaction of patients undergoing total hip arthroplasty but also reduce the incidence of complications.

Clinical Significance of the Static and Dynamic Q-angle

Q-angle represents the resultant force vector of the quadriceps and patellar tendons acting on the patella. An increased Q-angle has been considered a risk factor for many disorders and injuries. This literature review challenges the clinical value of static Q-angle and recommends a more dynamic movement evaluation for making clinical decisions. Although there are many articles about static Q-angle, few have assessed the value of dynamic Q-angle. We searched Scopus and PubMed (until September 2021) to identify and summarize English-language articles evaluating static and dynamic Q-angle, including articles for dynamic knee valgus (DKV) and frontal plane projection angle. We also used textbooks and articles from references to related articles. Although static Q-angle measurement is used systematically in clinical practice for critical clinical decisions, its interpretation and clinical translation present fundamental and intractable limitations. To date, it is acceptable that mechanisms that cause patellofemoral pain and athletic injuries have a stronger correlation with dynamic loading conditions. Dynamic Q-angle has the following three dynamic elements: frontal plane (hip adduction, knee abduction), transverse plane (hip internal rotation and tibia external rotation), and patella behavior. Measuring one out of three elements (frontal plane) illustrates only one-third of this concept. Static Q-angle lacks biomechanical meaning and utility for dynamic activities. Although DKV is accompanied by hip and tibia rotation, it remains a frontal plane measurement, which provides no information about the transverse plane and patella movement. However, given the acceptable reliability and the better differentiation capability, DKV assessment is recommended in clinical practice.

Similar Biomechanical Behavior in Gait Analysis between Ceramic-on-Ceramic and Ceramic-on-XLPE Total Hip Arthroplasties

In vitro measurements are widely used to implement gait kinematic and kinetic parameters to predict THA wear rate. Clinical tests of materials and designs are crucial to prove the accuracy and validate such measurements. This research aimed to examine the effect of CoC and CoXLPE kinematics and kinetics on wear during gait, the essential functional activity of humans, by comparing in vivo data to in vitro results. Our study hypothesis was that both implants would present the same hip joint kinematics and kinetics during gait. In total, 127 unilateral primary cementless total hip arthroplasties were included in the research. There were no statistically significant differences observed at mean peak abduction, flexion, and extension moments and THA kinematics between the two groups. THA gait kinematics and kinetics are crucial biomechanical inputs associated with implant wear. In vitro studies report less wear in CoC than CoXLPE when tested in a matched gait kinematic protocol. Our findings confirm that both implants behave identically in terms of kinematics in a clinical environment, thus strengthening CoC advantage in in vitro results. Correlated to all other significant factors that affect THA wear, it could address in a complete prism the wear on CoC and CoXLPE.