Kang Jeong Hoon, Lee Sang Hong, Jung Sung
Department of Orthopaedic Surgery, College of Medicine, Chosun University, Gwangju, Korea.
Hip Pelvis. 2015 Dec;27(4):232-40. doi: 10.5371/hp.2015.27.4.232. Epub 2015 Dec 30.
The current study aims to evaluate the clinical and the radiological outcome of bipolar hemiarthroplasty using cementless cone stem to treat osteoporotic femoral neck fracture and compare the results according to the proximal femur geometry.
Seventy-five hips (75 patients) that underwent bipolar hemiarthroplasty with cementless cone stem between September 2006 and December 2011 were analyzed. The minimum follow-up period was 3 years. Thirty-three hips were classified as type B and 41 as type C. The clinical outcome was assessed using Harris hip score and the walking ability score. Radiographic evaluation was performed to evaluate the stability of the prosthesis.
At the most recent follow up, the mean Harris hip score was 86 (range, 70-92) and 65% recovered to preoperative ambulatory status. In the radiographic exam, stable stem fixation was achieved in all cases. For the complications, eight hips developed deep vein thrombosis while three hips showed heterotopic ossification. Dislocation and delayed deep infection occurred in one hip resepectively. There were no significance differences in Harris hip score and walking ability score when the type B group was compare with the type C.
Bipolar hemiarthroplasty with cementless cone stem showed an excellent early outcome both clinically and radiographically regardless of the shape of the proximal femur. We believe this prosthesis can provide early stability to the Dorr type B and C femur and is an effective treatment for treating osteoporotic femoral neck fracture.
本研究旨在评估采用无骨水泥锥柄双极半髋关节置换术治疗骨质疏松性股骨颈骨折的临床和影像学结果,并根据股骨近端几何形状比较结果。
分析2006年9月至2011年12月期间接受无骨水泥锥柄双极半髋关节置换术的75例髋关节(75例患者)。最短随访期为3年。33例髋关节分类为B型,41例为C型。使用Harris髋关节评分和步行能力评分评估临床结果。进行影像学评估以评估假体的稳定性。
在最近一次随访时,平均Harris髋关节评分为86分(范围70 - 92分),65%的患者恢复到术前的行走状态。在影像学检查中,所有病例均实现了假体柄的稳定固定。并发症方面,8例髋关节发生深静脉血栓形成,3例髋关节出现异位骨化。各有1例髋关节发生脱位和迟发性深部感染。B型组与C型组在Harris髋关节评分和步行能力评分方面无显著差异。
无论股骨近端形状如何,采用无骨水泥锥柄的双极半髋关节置换术在临床和影像学方面均显示出良好的早期结果。我们认为这种假体可为Dorr B型和C型股骨提供早期稳定性,是治疗骨质疏松性股骨颈骨折的有效方法。