Choi Jung-Yun, Sung Yerl-Bo, Kim Joo-Hyung
Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Hip Pelvis. 2016 Dec;28(4):208-216. doi: 10.5371/hp.2016.28.4.208. Epub 2016 Dec 28.
To compare and analyze clinical and radiologic outcomes of cemented versus cementless bipolar hemiarthroplasty for treatment of femur neck fractures.
A total of 180 patients aged 65 years and over older who underwent bipolar hemiarthroplasty for treatment of displaced femur neck fractures (Garden stage III, IV) from March 2009 to February 2014 were included in this study. Among the 180 patients, 115 were treated with cemented stems and 65 patients with cementless stems. Clinical outcomes assessed were: i) postoperative ambulatory status, ii) inguinal and thigh pain, and iii) complications. The radiologic outcome was femoral stem subsidence measured using postoperative simple X-ray.
The cemented group had significantly lower occurrence of complications (postoperative infection, =0.04) compared to the cementless group. There was no significant difference in postoperative ambulatory status, inguinal and thigh pain, and femoral stem subsidence.
For patients undergoing bipolar hemiarthroplasty, other than complications, there was no statistically significant difference in clinical or radiologic outcomes in our study. Selective use of cemented stem in bipolar hemiarthroplasty may be a desirable treatment method for patients with poor bone quality and higher risk of infections.
比较并分析骨水泥型与非骨水泥型双极半髋关节置换术治疗股骨颈骨折的临床和影像学结果。
本研究纳入了2009年3月至2014年2月期间180例年龄65岁及以上因移位性股骨颈骨折（Garden III期、IV期）接受双极半髋关节置换术的患者。在这180例患者中，115例采用骨水泥型假体柄治疗，65例采用非骨水泥型假体柄治疗。评估的临床结果包括：i）术后行走状态，ii）腹股沟和大腿疼痛，iii）并发症。影像学结果是通过术后简单X线测量股骨假体柄下沉情况。
与非骨水泥型组相比，骨水泥型组并发症发生率（术后感染，=0.04）显著更低。术后行走状态、腹股沟和大腿疼痛以及股骨假体柄下沉情况无显著差异。
对于接受双极半髋关节置换术的患者，除并发症外，本研究中临床或影像学结果无统计学显著差异。在双极半髋关节置换术中选择性使用骨水泥型假体柄可能是骨质量差和感染风险较高患者的一种理想治疗方法。
