Department of Orthopaedic Surgery of the Onze Lieve Vrouwe Gasthuis , Amsterdam , the Netherlands.
Acta Orthop. 2013 Dec;84(6):555-60. doi: 10.3109/17453674.2013.867763. Epub 2013 Nov 29.
Numerous papers have been published on the medium- and long-term results of hemiarthroplasties (HAs) after femoral neck fracture in the elderly. We were not aware of any articles that describe the outcome of HA until the patient dies.
Between 1975 and 1989, 307 bipolar hemiarthroplasties were performed in 302 consecutive patients with a displaced femoral neck facture. Patients with osteoarthritis of the hip, rheumatoid arthritis (RA), or senile dementia were not included in the study. All patients were followed annually until they died or until they needed a revision operation.
The mortality rate was 28% after 1 year, and 63% after 5 years. The last patient who did not need a revision operation died in October 2010. Revision operations for aseptic loosening, protrusion, or both had to be performed in 34 patients (16%). A difference in reoperation rate was observed between patients less than 75 years of age (38%) and those who were older (6%).
Apart from age below 75 years, male sex appeared to be predictive of a revision operation. HA is a safe and relatively inexpensive treatment for patients over 75 years of age with a displaced femoral neck fracture.
大量文献已经发表了关于老年股骨颈骨折后半髋关节置换术（Hemiarthroplasty，HA）的中、长期疗效。我们不知道任何描述 HA 疗效的文章，直到患者死亡。
1975 年至 1989 年间，302 例连续股骨颈移位骨折患者进行了 307 例双极半髋关节置换术。未包括髋关节骨关节炎、类风湿关节炎（Rheumatoid Arthritis，RA）或老年痴呆症患者。所有患者每年随访一次，直至死亡或需要进行翻修手术。
1 年后死亡率为 28%，5 年后为 63%。最后一位无需进行翻修手术的患者于 2010 年 10 月去世。因无菌性松动、突出或两者均需进行翻修手术的患者有 34 例（16%）。我们观察到年龄小于 75 岁的患者（38%）与年龄较大的患者（6%）之间的翻修手术率存在差异。
除年龄小于 75 岁外，男性似乎也是需要进行翻修手术的预测因素。HA 是 75 岁以上股骨颈移位骨折患者安全且相对廉价的治疗方法。
