不同类型假体全髋关节置换术对老年股骨颈骨折患者疗效和安全性的影响

Effects of Different Types of Total Prosthetic Total Hip Arthroplasty on Efficacy and Safety of Femoral Neck Fractures in the Elderly

目的:探讨不同类型假体全髋关节置换术对老年股骨颈骨折患者疗效和安全性的影响。方法:回顾性分析2015年7月—2016年12月我院行髋关节置换术的90例单一股骨颈骨折老年患者的临床资料,其中采用骨水泥型假体43例(观察组),47例采用生物型假体(对照组)。比较两组患者术中术后情况、Harris评分及并发症,并对术后1年随访髋关节优良率情况进行分析。结果:观察组手术时间明显短于对照组,术中出血量及术后引流量明显少于对照组,两组比较差异有统计学意义(P <0. 05)。观察组术中发生骨水泥反应4例,术后随访中发生1次溶骨性疾病;对照组术后随访发生2例溶骨性疾病,两组比较差异无统计学意义(P> 0. 05)。术前,两组患者的Harris功能及疼痛评分差异无统计学意义(P> 0. 05)。术后1年,两组患者的Harris功能及疼痛评分均明显增加,且观察组明显高于对照组,两组比较差异有统计学意义(P <0. 05),观察组患者术后1年随访优良率比对照组明显更高,差异有统计学意义(P <0. 05)。结论:单一股骨颈骨折高龄患者全髋关节置换术应用骨水泥型的术中出血、术后引流以及疗效均优于生物假体,但并发症无明显优势。

Objective:To investigate the effect of different types of prosthesis total hip arthroplasty on the efficacy and safety of elderly patients with femoral neck fracture.Methods:The clinical data of 90 elderly patients with single femoral neck fracture in our hospital from July 2015 to December 2016 were analyzed retrospectively.Among them,43 cases were used cemented prosthesis(observation group),and 47 cases were used bio-prosthesis(control group).The observation group used the application of bone cement prosthesis,the control group used biological prosthesis.The postoperative and postoperative rates,Harris score,and after 1 year follow-up rate of hip joint and complications were compared between the two groups.Results:The operative time in the observation group was significantly shorter than that in the control group,and the intraoperative blood loss and postoperative drainage volume were significantly less than those in the control group.The difference between the two groups was statistically significant(P<0.05).In the observation group,4 cases of bone cement reaction occurred during the operation,and 1 osteolytic diseases occurred during the follow-up,and 2 cases of osteolytic disease were followed up in the control group.There was no significant difference in the difference between the two groups(P>0.05).Before operation,there was no significant difference in Harris function and pain score between the two groups(P>0.05).1 year after surgery,two groups of patients with Harris function and pain scores were significantly increased,and the observation group was significantly higher than the control group,there was significant difference between two groups(P<0.05),the patients in the observation group after 1 year of follow-up than the control group the excellent rate was significantly higher,the difference was statistically significant(P<0.05).Conclusion:A single femoral neck fracture in elderly patients with total hip arthroplasty using the type of intraoperative bleeding,postoperative drainage and efficacy are better than the bioprosthesis,but no significant complications.