Warwick Orthopaedics, Warwick MedicalSchool, University of Warwick, CoventryCV4 7AL, UK, and UniversityHospitals Coventry and Warwickshire NHS Trust, CliffordBridge Road, Coventry CV2 2DX, UK.
Bone Joint Res. 2013 Oct 2;2(10):210-3. doi: 10.1302/2046-3758.210.2000186. Print 2013.
Fractures of the proximal femur are one of the greatest challenges facing the medical community, constituting a heavy socioeconomic burden worldwide. Controversy exists regarding the optimal treatment for independent patients with displaced intracapsular fractures of the proximal femur. The recognised alternatives are hemiarthroplasty and total hip replacement. At present there is no established standard of care, with both types of arthroplasty being used in many centres. The principal advantages of total hip replacement are a functional benefit over hemiarthroplasty and a reduced risk of revision surgery. The principal criticism is the increased risk of dislocation. We believe that an alternative acetabular component may reduce the risk of dislocation but still provide the functional benefit of total hip replacement in these patients. We therefore propose to investigate the dislocation risk of a dual-mobility acetabular component compared with standard polyethylene component in total hip replacement for independent patients with displaced intracapsular fractures of the proximal femur within the framework of the larger WHiTE (Warwick Hip Trauma Evaluation) Comprehensive Cohort Study. Cite this article: Bone Joint Res 2013;2:210-13.
股骨近端骨折是医学界面临的最大挑战之一,在全球范围内造成了沉重的社会经济负担。对于无移位的囊内股骨近端骨折的独立患者,哪种治疗方法最佳存在争议。公认的选择是半髋关节置换术和全髋关节置换术。目前,尚无既定的治疗标准,许多中心都在使用这两种关节置换术。全髋关节置换术的主要优点是在功能上优于半髋关节置换术,并且翻修手术的风险降低。主要的批评意见是脱位风险增加。我们认为,对于无移位的囊内股骨近端骨折的独立患者,使用双动髋臼组件可能会降低脱位风险,但仍能提供全髋关节置换术的功能益处。因此,我们建议在更大的 Warwick Hip Trauma Evaluation(WHITE)综合队列研究框架内,研究双动髋臼组件与全髋关节置换术中标准聚乙烯组件相比的脱位风险。
Bone Joint Res 2013;2:210-13.