骨水泥型和生物型股骨假体半髋置换修复高龄股骨颈骨折

背景：高龄患者移位的股骨颈骨折可采用人工股骨头置换修复，但该患者群体骨量往往不佳，采用骨水泥或生物型股骨假体一直存在争论。 目的：对比分析高龄移位型股骨颈骨折患者采用骨水泥及生物型股骨假体半髋置换的效果。 方法：2011年1月至2012年12月采用骨水泥型股骨假体半髋置换修复高龄移位型股骨颈骨折26髋，采用生物型股骨假体治疗同类型患者30髋。对比两组患者手术时间、术中出血量、置换后引流量以及并发症发生情况。置换后采用Harris评分系统进行髋关节临床功能评价。 结果与结论：随访时间20-44个月，两组骨水泥或生物型假体置换后效果均满意，置换后12个月Harris髋关节评分优良率分别为89%和83%，差异无显著性意义。两组术中出血量及置换后引流量差异无显著性意义，但生物型假体组手术时间更短(P < 0.01)。两组患者在随访期内未出现关节松动、下沉、感染及脱位等并发症。表明对于骨量不佳的高龄移位型股骨颈骨折患者，生物型半髋置换能取得与骨水泥型半髋置换同样良好的修复效果。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：

Cement and cementless hemi-hip replacement for the repair of femoral neck fracture in the elderly

BACKGROUND:Artificial femoral head replacement is an effective measure for displaced femoral neck fracture in the elderly, but the bone mass is poor in these patients. There is a controversy in the selection of bone cement or cementless femoral prosthesis. OBJECTIVE:To compare the clinical efficacy of bone cement and cementless femoral prosthesis in elderly patients with displaced femoral neck fracture. METHODS:From January 2011 to December 2012, 26 hips with displaced femoral neck fracture were treated with cement hemi-hip arthroplasy and 30 hips were treated with cementless femoral implants. Surgery time, intraoperative bleeding, postoperative drainage, postoperative complications were compared between the two groups. Hip function was evaluated according to Harris hip score system. RESULTS AND CONCLUSION:All patients were followed up for 20-44 months. The clinical results were satisfied. At 12 months after replacement, excellent-to-good rate of cement group and cementless group was 89% and 83%, respectively according to Harris hip score evaluation with no significant differences. There were no statistic difference between two groups in intraoperative blood loss and postoperative drainage, but operative time in cement group was longer than in cementless group (P < 0.01). There was no prosthesis loosening, subsidence, infection or joint dislocation during follow-up in both groups. These findings suggested that cementless prosthesis hemi-hip replacement can get good clinical results as cement prosthesis replacement for treatment of displaced femoral neck fracture in elderly patients.