双动半髋关节置换及全髋关节置换修复高龄转子间骨折的对比

背景：双动半髋关节置换及全髋关节置换均是治疗老年股骨转子间骨折的可靠方法，但具体哪种方式疗效更好临床上仍有争议。 目的：观察人工关节置换的不同方案用于高龄转子间骨折患者的实际疗效，评价其临床应用价值。 方法：选择54例65岁以上的高龄转子间骨折患者，随机分为观察组27例，采用分次骨水泥双动人工关节置换进行治疗；对照组27例，采用骨水泥人工全髋关节置换进行治疗，随访2年，记录两组患者Harris得分以评估疗效，随访复发率、不良事件及材料宿主反应。 结果与结论：应用分次骨水泥双动人工关节置换的观察组疗效与对照组相似(89%，81%，P > 0.05)，但2年随访复发率明显低于对照组(4%，30%，P < 0.05)，且均未发生脱位、髋臼磨损、假体松动等严重并发症。结果提示，分次骨水泥双动人工关节置换用于高龄转子间骨折的中期效果与全髋关节置换相似，但显著降低了复发率。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 

Double-action hemiarthroplasty versus total hip arthroplasty for intertrochanteric fracture in the elderly

BACKGROUND:Doubld-action hemiarthroplasty and total hip arthroplasty are reliable methods to treat intertrochanteric fracture of femur in the elderly, but which is better remains controversial in the clinic. OBJECTIVE:To observe the practical effect of prosthetic replacement with different methods in treatment of intertrochanteric fracture of femur in the elderly, and to assess the clinical value. METHODS:A total of 54 elderly patients with intertrochanteric fracture of femur at the age of over 65 years old were randomly assigned to two groups. In the observation group (n=27), patients underwent graded cement double-action arthroplasty. In the control group (n=27), patients received cementless total hip arthroplasty. They were followed up for 2 years. Harris scores were recorded in the two groups so as to assess the therapeutic effects. Follow-up recurrence rate, adverse events and host response to materials were analyzed. RESULTS AND CONCLUSION:The therapeutic effects were similar between the observation and control groups (89%, 81%; P > 0.05), but recurrence rate of 2-year follow-up was significantly lower in the observation group than in the control group (4%, 30%; P < 0.05). Moreover, dislocation, acetabular wear and loosening were not found. Results indicate that the midterm effects were similar between graded cement double-action arthroplasty and total hip arthroplasty in treatment of intertrochanteric fracture in the elderly, but graded cement double-action arthroplasty significantly decreases the recurrence rate.