改良后路小切口髋关节置换术对老年股骨颈骨折患者髋关节功能及术后PINP、BAP、BGP水平的影响

目的 探究改良后路小切口髋关节置换术对老年股骨颈骨折患者髋关节功能及术后Ⅰ型前胶原氨基端前肽(PINP)、骨钙素(BGP)、骨特异性磷酸酶(BAP)的影响.方法 回顾性选取2018年1月至2019年12月首都医科大学附属北京潞河医院收治的110例老年股骨颈骨折行髋关节置换术的患者为研究对象.按照采取的置换术入路方式不同...

Effect of modified posterior small incision hip replacement on hip function and postoperative PINP,BAP,BGP in elderly patients with femoral neck fracture.

Objective To investigate the effects of modified posterior mini-incision hip arthroplasty on hip function and postoperative typeⅠprocollagen amino-terminal propeptide(PINP),osteocalcin(BGP)and bone specific phosphatase(BAP)in elderly patients with femoral neck fracture.Methods A toal of 110 elderly patients with femoral neck fractures who underwent hip replacement and were admitted to Beijing Luhe Hospital,Capital Medical University from January 2018 to December 2019 were retrospectively selected as research subjects.According to the different approaches of replacement surgery,they were divided into anterior hip approach group(control group)and modified small incision approach group(observation group),with 55 cases in each group.Perioperative indicators,preoperative and postoperative Harris score changes,serum PINP,BGP,BAP content changes,excellent treatment rate,complications and other indicators of the two groups were observed and compared.Results The incision length,operation time,intraoperative blood loss,1 d after surgery VAS score and postoperative ground time in the observation group were(13.08±1.26)cm,(99.43±15.48)min,(162.59±25.29)mL,(4.48±1.04)points,(1.93±0.69)d,respectively,which were lower than those in the control group(15.42±1.38)cm,(101.39±14.44)min,(173.84±25.29)mL,(6.42±1.04)points,(2.73±0.64)d],the differences were statistically significant(P<0.05).One month after surgery,the levels of PINP,BAP and BGP in observation group were(1024.39±89.21)pg/L and(40.87±4.92)ng/mL,(9.77±1.42)ng/mL,respectively,which were higher than those in the control group(848.72±53.46)pg/L,(33.54±4.76)ng/mL,(8.58±1.03)ng/mL],the differences were statistically significant(P<0.05).The Harris scores of observation group at 1 month and 6 months after operation were(79.76±6.36)and(85.46±7.03)points,which were higher than those of control group(71.27±8.93)and(79.68±7.92)points],the differences were statistically significant(P<0.05).The excellent and good rate of the observation group was 90.91%,which was higher than 76.36%in the control group,and the complication rate of the observation group was 5.45%,which was lower than 12.73%in the control group,the differences were statistically significant(P<0.05).Conclusion Modified posterior small incision hip replacement surgery can recover hip function faster in elderly patients with femoral neck fractures,better improve perioperative adverse indicators,reduce complications,and increase the expression level of bone metabolism-related factors,which is beneficial to patients recover.