Inngul C, Blomfeldt R, Ponzer S, Enocson A
Södersjukhuset, Stockholm, Sweden.
Bone Joint J. 2015 Nov;97-B(11):1475-80. doi: 10.1302/0301-620X.97B11.36248.
The aim of this randomised controlled study was to compare functional and radiological outcomes between modern cemented and uncemented hydroxyapatite coated stems after one year in patients treated surgically for a fracture of the femoral neck. A total of 141 patients aged > 65 years were included. Patients were randomised to be treated with a cemented Exeter stem or an uncemented Bimetric stem. The patients were reviewed at four and 12 months. The cemented group performed better than the uncemented group for the Harris hip score (78 vs 70.7, p = 0.004) at four months and for the Short Musculoskeletal Function Assesment Questionnaire dysfunction score at four (29.8 vs 39.2, p = 0.007) and 12 months (22.3 vs 34.9, p = 0.001). The mean EQ-5D index score was better in the cemented group at four (0.68 vs 0.53, p = 0.001) and 12 months (0.75 vs 0.58, p = < 0.001) follow-up. There were nine intra-operative fractures in the uncemented group and none in the cemented group. In conclusion, our data do not support the use of an uncemented hydroxyapatite coated stem for the treatment of displaced fractures of the femoral neck in the elderly.
这项随机对照研究的目的是比较在接受手术治疗股骨颈骨折的患者中，现代骨水泥型和非骨水泥型羟基磷灰石涂层假体柄在术后一年的功能和影像学结果。共纳入141例年龄大于65岁的患者。患者被随机分配接受骨水泥型Exeter假体柄或非骨水泥型Bimetric假体柄治疗。在4个月和12个月时对患者进行复查。在4个月时，骨水泥组的Harris髋关节评分（78分对70.7分，p = 0.004）以及在4个月（29.8分对39.2分，p = 0.007）和12个月（22.3分对34.9分，p = 0.001）时的短肌肉骨骼功能评估问卷功能障碍评分方面均优于非骨水泥组。在4个月（0.68对0.53，p = 0.001）和12个月（0.75对0.58，p = < 0.001）随访时，骨水泥组的平均EQ-5D指数评分更高。非骨水泥组有9例术中骨折，骨水泥组无术中骨折。总之，我们的数据不支持使用非骨水泥型羟基磷灰石涂层假体柄治疗老年股骨颈移位骨折。
