仿生双动髋关节假体置换与常规髋关节假体置换治疗股骨颈骨折的临床效果比较

Comparison of Clinical Effects between Dual-mobility Acetabular Cups and Conventional Acetabular Prosthesis Replacement in the Treatment of Femoral Neck Fracture

目的比较仿生双动髋关节假体置换与常规髋关节假体置换治疗股骨颈骨折患者临床效果。方法选择2019年3月—2021年3月在光泽县医院进行手术治疗的股骨颈骨折患者100例,随机分为观察组和对照组各50例。观察组给予仿生双动髋关节假体置换术治疗,对照组给予普通髋关节假体置换术治疗,比较两组术后恢复情况和1年内并发症发生情况。结果观察组患者术后初次自主下蹲时间、术后初次自主穿脱袜子时间、术后初次自主上下楼梯时间短于对照组,差异有统计学意义(P<0.05);术后6个月、术后12个月,两组视觉模拟评分法评分逐渐降低,且观察组低于对照组,差异有统计学意义(P<0.05);术后1个月、术后12个月,两组患者Mayo髋关节功能评分、Harris髋关节功能量表评分升高,且观察组评分高于对照组,差异有统计学意义(P<0.05);术后6个月,观察组患者假体下沉深度低于对照组,观察组患者骨盆冠状面倾斜角度高于对照组,差异有统计学意义(P<0.05);术后12个月,两组假体下沉深度、骨盆冠状面倾斜角度较术后3个月增加,但观察组假体下沉深度低于对照组,观察组骨盆冠状面倾斜角度高于对照组,观察组假体松动及脱位率低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论与常规髋关节假体置换相比,仿生双动髋关节假体置换术治疗股骨颈骨折患者,术后恢复快,疼痛缓解,髋关节活动度、功能得以提升,髋关节稳定性提升,并发症少。

Objective To compare the clinical effects of dual-mobility acetabular cups and conventional hip prosthesis replacement in the treatment of femoral neck fracture.Methods A total of 100 patients with femoral neck fracture who underwent surgical treatment in Guangze County Hospital from March 2019 to March 2021 were selected.They were randomly divided into bionic group(50 cases)and common group(50 cases).The bionic group was treated with dual-mobility acetabular cups,and the common group was treated with conventional acetabular prosthesis replacement.The recovery of two groups were compared after treatment,and the complication rate were compared between two groups after 1 year.Results The time of the patients in the bionic group for the first time to squat,put on and take off socks,and go up and down stairs was significantly shorter than that in the common group(P<0.05).At 6 months and 12 months after operation,the VAS score of patients in the two groups decreased gradually(P<0.05),and the VAS score of patients in the bionic group was significantly lower than that in the common group(P<0.05).At 1 month and 12 months after operation,the MHS and HHS scores of patients in the two groups increased(P<0.05),and the MHS and HHS scores of patients in the bionic group were significantly higher than those in the normal group(P<0.05).At Six months after operation,the prosthesis sinking depth of patients in the bionic group was significantly lower than that of the common group(P<0.05),and the pelvic coronal plane inclination angle of patients in the bionic group was significantly higher than that of the common group(P<0.05).At 12 months after operation,the prosthesis sinking depth and pelvic coronal plane inclination angle of patients in the bionic group were significantly increased compared with those before 3 months(P<0.05),but the prosthesis sinking depth of the bionic group was significantly lower than that of the common group(P<0.05),the pelvic coronal plane inclination angle of patients in the bionic group was significantly higher than that of the common group(P<0.05),and the rate of prosthesis loosening and dislocation in bionic group was significantly lower than that in common group(P>0.05).The complication rate of the bionic group was significantly lower than that of the common group(2.00%vs 14.00%)(P<0.05).Conclusion Compared with the conventional hip joint replacement,dual-mobility acetabular cups for patients with femoral neck fracture can recover quickly,relieve pain,improve the range of motion and function of the hip joint,improve the stability of the hip joint,and have fewer complications.