Department of Orthopaedics, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
J Orthop Trauma. 2012 Mar;26(3):135-40. doi: 10.1097/BOT.0b013e318238b7a5.
To prospectively compare the functional outcome associated with cemented and uncemented hemiarthroplasty.
Prospective randomized control trial.
University-affiliated level 1 trauma center.
PATIENTS/PARTICIPANTS: All individuals designated for hemiarthroplasty, older than 55 years, with a nonpathologic displaced femoral neck fracture and the ability to ambulate 10 feet independently before injury [269 patients (274 hips) presented with displaced femoral neck fracture, 130 patients (48.3%) enrolled, and 5 patients (3.8%) withdrew].
Hip hemiarthroplasty with a cemented femoral prosthesis (VerSys LD/Fx; Zimmer, Warsaw, IN) or an uncemented component (VerSys Beaded FullCoat; Zimmer, Warsaw, IN).
Instrumental Activities of Daily Living and Physical Activities of Daily Living scales (Older Americans Resources and Services Instrument) and the Energy/Fatigue Scale.
No statistically significant differences were present in the groups' preoperative or intraoperative characteristics, including American Society of Anesthesiologists grade, operative time, anesthesia time, use of perioperative β-blockers, estimated blood loss, or the rate of intraoperative fracture. Postoperatively, no difference was found in hemoglobin level, transfusion rate, discharge disposition, or acute complication rate. At 30-day, 60-day, and 1-year follow-ups, no clinically or statistically significant differences were found in mortality, disposition, need for assistance with ambulation, Older Americans Resources and Services Activities of Daily Living subscales, or the Energy/Fatigue Scale.
In the treatment of nonpathologic displaced femoral neck fractures, the use of cemented and uncemented femoral components is associated with similar functional outcome at 1 year. Practitioners may inform their clinical decisions using these equally good results.
Therapeutic Level II. See page 128 for a complete description of levels of evidence.
前瞻性比较骨水泥型和非骨水泥型人工半髋关节置换术的功能结果。
前瞻性随机对照试验。
大学附属 1 级创伤中心。
患者/参与者：所有被指定行人工半髋关节置换术的患者，年龄大于 55 岁，有非病理性移位股骨颈骨折，受伤前有独立行走 10 英尺的能力[269 例（274 髋）为移位股骨颈骨折患者，其中 130 例（48.3%）入组，5 例（3.8%）退出]。
骨水泥型股骨假体（VerSys LD/Fx；Zimmer，Warsaw，IN）或非骨水泥型组件（VerSys 珠状全涂层；Zimmer，Warsaw，IN）行髋关节半髋关节置换术。
工具性日常生活活动和日常生活活动量表（美国老年人资源和服务工具）和能量/疲劳量表。
组间术前或术中特征，包括美国麻醉医师协会分级、手术时间、麻醉时间、围手术期β受体阻滞剂的使用、估计失血量或术中骨折发生率均无统计学差异。术后血红蛋白水平、输血率、出院处置和急性并发症发生率无差异。在 30 天、60 天和 1 年随访时，死亡率、出院处置、行走需要协助、美国老年人资源和服务日常生活活动亚量表或能量/疲劳量表无临床或统计学差异。
在治疗非病理性移位股骨颈骨折时，使用骨水泥型和非骨水泥型股骨假体 1 年后功能结果相似。临床医生可以根据这些同样良好的结果做出临床决策。
治疗水平 II。有关证据水平的完整描述，请参见第 128 页。
