Artificial total medullary arthroplasty (Otalhipart’horpalsty, THA) has now become a reliable and effective surgical treatment for severe indigo arthropathy. Although traditional surgical incision for medullary arthroplasty can complete the operation better, but it requires complete and full exposure of the joint site. in the mid-1990s, some doctors began to try to integrate the concept of minimally invasive surgery into THA. 207 skeletons were replaced by posterior lateral small incision from October 202 to January 205, and the results of the treatment were satisfactory. I. DATA AND METHODS 1. Clinical data: 19 patients (207 medulla) of which 28 were male (68 medulla) and 117 were female (121 medulla); age 31 1 8 years old, average 60 years old. Among them, 129 cases of ischemic necrosis of femoral head with 136 marrow, 3 cases of simultaneous replacement; 46 cases of femoral neck fracture with 46 marrow, of which 31 cases of fresh fracture with 31 marrow, old fracture with coincident cases with coincident marrow; 12 cases of medullary socket dysplasia with traumatic arthritis with 13 marrow; 7 cases of medullary joint ankylosis left after septic infection; 5 cases of osteoarthritis. The average preoperative Hams score was 48 (12). There were 37 cases of diabetes mellitus. The prostheses chosen were non-cemented Trifogy medullary socket and Versys femoral stem prosthesis (Ziluner Company, USA). 2. Surgical method: The patient was placed in the healthy side lateral position. (1) Skin incision: the posterior edge of the greater trochanter was slightly curved backward arc-shaped incision, the proximal section of the incision and the gluteus maximus muscle fiber alignment dagger. The proximal 1 is above the apex of the greater trochanter. The length of the incision is 6 scm, and the part of the incision above the apex of the greater trochanter is appropriately reduced in the case of severe femoral head collapse. (2) Exposure and femoral neck osteotomy: cut the skin and subcutaneous, from the deep fascia under the gluteus maximus muscle and the superficial surface of the broad fascia bluntly free, forming a mobile window (also conducive to the tight closure of the incision). The broad fascia (gluteal fascia) is incised along the posterior aspect of the trochanter, and part of the gluteus maximus fiber bundle is incised upward along the course of the gluteus maximus fibers. After blunt separation to expose the fat layer outside the joint capsule, the periosteal stripper separates the joint capsule from the gluteus medius and minimus interspace, strips the pterygoid muscle at the stopping point, and cuts through the joint capsule in the shape of a “U” to expose the osteotomy part of the femur, and then performs an osteotomy of the neck of the femur according to the results of the preoperative X-ray film to take out the femoral head under direct vision. (3) Preparation of the medullary socket and implantation of the prosthesis: The MIS medullary socket hook was used to gradually reveal the medullary socket and clean up the glenoid labrum, and to excise the growths of the bony cumbersome bone and the remnants of the round ligament. After the bony socket rim is completely exposed, the socket is routinely grinded. For patients with obvious preoperative limitation of skeletal joint movement, it is necessary to utilize the MIS hook to fully reveal the peri-marrow socket during the operation, and at the same time loosen the peri-marrow adhesive tissues, especially anterior and medial adhesions, under the “mobile window”, to gradually increase the mobility; if there are defects or dysplasia in the socket (Crown L1NL), the socket should be reconstructed by transplanting autologous femoral head or allograft bone into the socket. The socket is reconstructed with autologous femoral head or allograft bone graft. After the preparation of the socket is satisfactory, a prosthesis is implanted. (4) Femur preparation and implantation of prosthesis: Bend the knee and internally rotate the femur 90, make the calf perpendicular to the operating table, use the “Jaws” arc retractor to elevate the proximal end of the femur, the medullary socket hook is placed on the femur big and small thick part of the femur can clearly reveal the femoral neck. After determining the anterior tilt angle of about 20, close to the lateral groove of the greater trochanter, manually expand the medulla, in turn, expand the medulla to the appropriate type, place the test model and reset the medullary joint, test the range of motion and stability of the medullary joint (flexion>10″, posterior extension>10″, internal rotation>60″), and the equilibrium of the lower limbs is satisfactory. The prosthesis is then placed. (5) Incision suture: negative pressure drainage is placed. The posterior joint capsule and the peeled pyriformis muscle stop were sutured forward to the posterior edge of the gluteus medius muscle stop with PDS absorbable loop suture. Subsequently, the broad fascia and gluteus maximus fascia were closed with PDS absorbable loop suture, and the subcutis was closed with absorbable suture to close the incision. After the operation, patients with supine adductor muscle tension resulting in limited abduction were treated with adductor muscle release. Post-operative treatment: If the hemoglobin is lower than 07 years old, blood transfusion will be given. On the first postoperative day, medullary joint function and quadriceps and power and static training were started. After removing the drainage tube on the next day after surgery, patients were encouraged to walk on the ground without weight-bearing with the help of crutches. Weight bearing was started 6 weeks after surgery (patients with medullary socket implantation also started partial weight bearing 6 weeks after surgery, and complete weight bearing was started within 12 weeks after surgery). 4.Evaluation method::Harris score was performed at the postoperative follow-up. 5.Statistical methods: the data of the cases in this group were expressed in unsigned, and the software SPSSn.0 was used for data processing. II.RESULTS The follow-up of this group was 6 a 26 months (average 12 months). The length of the surgical incision (7.4士1.3)Cm(所有切口都<10Cm);Intraoperative hemorrhage (365*155)ml, postoperative drainage (151士66)ml.Operative(Operative)andPostoperativeBlood transfusion 12 cases, the average amount of transfusion of 512 ml(400 a 80 ml),3samplesofbilateralsimultaneousreplacementcasesweretransfusedpostoperatively.The average amount of transfusion was 512 ml(400 a 80 ml), 3 cases of bilateral simultaneous replacement of the case to be transfused after the operation. The hospitalization time of all patients was (12-4) d. The postoperative X-ray films of all patients showed that the prosthesis was in good position. 3 cases of dislocation occurred after 3 medulla oblongata surgeries, 2 of which were posterior dislocations, and 1 anterior dislocation. 3 patients were over 70 years old, and the dislocations occurred within 1 month after the surgery. 1 anterior dislocation occurred after family members excessively lifted the medulla oblongata when the patient was lying down in bed and using a bedpan in the 4d postoperative period, and the two posterior dislocations occurred when the patient was discharged from hospital when he was sitting on the chair and couch. The two posterior dislocations occurred after discharge from the hospital when sitting on chairs and sofas. Three patients were reset by fluoroscopy under suction anesthesia, and they were put in bed with thong shoes for 3 weeks, and the posterior dislocation did not recur. 1 patient with postoperative medullary joint ankylosis after septic infection had a sinus in the incision at 13 months postoperatively, the sinus was located outside of the joint after surgical exploration, and it was resected, and the postoperative pathology suggested tuberculosis, and it was treated with anti-rash, and the 4 cases of 4 medullary incision with delayed postoperative healing were healed in 1 month postoperatively after changing the medication. There were no intraoperative medullary and proximal femoral fractures in this group of cases, and there were no postoperative complications such as infection and nerve injury. None of the patients had postoperative ultrasound-indicated DVT. The patients started the functional training of medullary joints in bed on the first day after surgery, and the time of brachiation with crutches was (2.8-0.8) d. 191 cases started weight-bearing walking at 6 weeks after medullary surgery in 198 cases, and the remaining 8 cases started weight-bearing walking at 12 weeks after medullary surgery in the remaining 8 cases (the patients could not give up the crutches in time due to the patients' age and muscular strength). Six months postoperative follow-up Harris score improvement averaged (39士8)分，and postoperative average (85士8)分.