Surgical technique and relevant perioperative treatment
thrombosis, quadriceps femoris isometric contraction, pneumonia, fracture, anemia, pain, abduction
THROMBOSIS, PNEUMONIA, DEEP VEIN THROMBOSIS, ANEMIA, COMPLICATIONS
Due to the short duration of primary THA, patients were treated with non-catheter combined spinal-epidural anesthesia or general anesthesia, intravenous prophylactic antibiotics 30 min before surgery, and pre-emptive analgesia with an oral dose of 200 mg celecoxib. The surgery was performed by two orthopedic surgeons with extensive experience in joint replacement surgery, using a posterolateral approach and a non-cemented prosthesis. Anticoagulation with 4000 IU low-molecular weight heparin was started 8 h after the procedure. Antibiotics were administered prophylactically until 24 h after surgery. Postoperative analgesia was treated with parecoxib 40 mg M Bid. Immediately after recovery of lower limb sensory activity, the patients were instructed to perform ankle joint active flexion and extension activities and quadriceps femoris isometric contraction exercises. On the first day after operation, the X-ray film was taken to confirm that there was no periprosthetic fracture, and the patient began to ambulate, and guided the hip joint flexion and abduction functional exercise.All patients enrolled in the study was assessed for pain level acccording to the Standard Operation Procedure (SOP). The pain score (from 0–10, 0 represents no pain and 10 represents the maximum pain level) was assessed by the Visual Analog Scale (VAS) every 4 h from the recovery of lower limb sensory activity on the day of surgery to the third day after surgery, and the VAS score was compared by daily averages. Oral tramadol sustained-release tablets (50 mg) or multiple doses were used for pain relief if the patient's pain symptoms were severe.All patients had routine blood tests, coagulation-related indicators and inflammatory indicators including high-sensitivity CRP, IL-6 and ESR reviewed daily for three days after surgery, and imaging data examination and deep vein ultrasound of the lower extremities were performed on the second postoperative day after drainage was removed to rule out deep vein thrombosis. Patients with hemoglobin values less than 70 g/L or between 70 and 100 g/L but with significant symptoms of anemia were treated with red blood cell transfusion to correct anemia. All patients were encouraged to walk immediately on the first postoperative day to reduce adverse complications such as pneumonia and thrombosis caused by bed rest.