高龄骨质疏松患者应用生物型全髋与半髋关节置换的临床疗效研究

目的 全髋关节置换术与双极人工股骨头置换术是治疗骨质疏松性股骨颈骨折患者的重要选择，探讨生物型髋关节假体对骨质疏松性股骨颈骨折的治疗作用。方法 回顾笔者医院2013年6月~2015年5月收治并已确诊的骨质疏松性股骨颈骨折患者60例，包含生物型全髋关节置换患者和生物型假体柄半髋关节置换患者各30例。对比分析两组患者手术时间、术中失血量、在院时间、治疗1年后并发症发生情况和髋关节Harris功能评分。结果 生物型全髋关节置换组术前内科基础疾病发生率显著低于半髋置换组。半髋置换组手术时间与术中出血量均低于生物型全髋关节置换组；两组患者住院时间与并发症发生率的比较，差异无统计学意义（P>0.05）；治疗1年后，生物型全髋关节置换组患者髋关节功能Harris评分优良率（93.3%）明显高于半髋置换组（83.3%，P=0.033）。结论 生物型髋关节假体治疗骨质疏松性股骨颈骨折疗效满意。虽然全髋置换更有助于改善患者的生活范围和生存质量，但双极股骨头置换在一般状况差的高龄患者中仍能取得满意疗效。

Clinical Analysis of Cementless Hip Arthroplasty and Bipolar Hemianthroplasty for Osteoporotic Femoral Neck Fracture in the Elderly

Objective Total hip arthroplasty and bipolar hemiarthroplasty are the important method to treat osteoporotic femoral neck fracture in elder patients. We investigated the effect of cementless arthroplasty on these patiens. Methods Sixty elder patients were selected who were diagnosed as osteoporotic femoral neck fracture from June 2013 to February 2016. Thirty patients were treated by cementless total hip arthroplasty and another half were treated by cementless bipolar hemiarthroplasty. We analyzed the operative time, blood loss, length of stay, complication rate and Harris score after 1 year between the two groups. Results The operative time and blood loss in the patients treated by cementless bipolar hemiarthroplasty were lower than those treated by cementless total hip arthroplasty. There were no differences of length of stay and complication rate between them. After the postoperative 1 year, the superior rate from Harris score in the patients treated by cementless total hip arthroplasty (93.3%) was higher than that in the patients treated by cementless bipolar hemiarthroplasty (83.3%, P<0.05). Conclusion Good results can be obtained with the intervention of cementless total hip arthroplasty and bipolar hemiarthroplasty. Although total hip arthroplasty showed better activity and quality in the daily life, bipolar hemiarthroplasty could also get enough satisfaction for the elder patients with worse physical health.