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全髋关节置换术中的短股骨柄:老年患者的稳定固定及低并发症发生率

Short femoral stem in total hip arthroplasty: stable fixation and low complication rates in elderly patients.

作者信息

Morales de Cano Jaime J, Gordo Christian, Canosa Areste Jordi

机构信息

Orthopaedic Surgery, Hospital del Vendrell, El Vendrell - Spain.

出版信息

Hip Int. 2017 Jul 25;27(4):311-316. doi: 10.5301/hipint.5000470. Epub 2017 Jan 31.

Abstract

BACKGROUND

We present the result of our experience in using a short femoral stem in elderly patients (>70 years of age) compared to patients younger than 70 years.

METHODS

Data were prospectively collected on 138 patients who underwent 148 primary total hip arthroplasty (THA), with a conservative short stem between November 2010 and June 2014. The cohort was divided into 2 groups: the study group (group 1) comprised 57 patients (60 THA) over 70 years of age at the time of surgery, with a mean age of 75.4 years (range 70-87 years) and a mean follow-up of 26.7 months (range 9-48 months). The control group (group 2) comprised 81patients (88 THA) less than 70 years of age with a mean age of 57.4 years (range 33-69 years) and a mean follow-up of 27.3 months (range 9-54 months). Hip function in the 2 groups was compared preoperatively and postoperatively using the Merle D'Aubigne hip score (MD) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score.

RESULTS

At the latest follow-up, 1 calcar fracture was reported in a 54-year-old patient in the control group, which required fixation with a screw and had a favourable outcome. No cases of clinical or radiographic loosening were reported.Clinical results showed no statistically significant differences between the 2 groups.

CONCLUSIONS

The use of the GTS conservative short stem in patients over 70 years old has shown very good results and low complication rates, comparable to those for patients younger than 70 years.

摘要

背景

我们展示了在老年患者(年龄>70岁)中使用短柄股骨假体与70岁以下患者相比的经验结果。

方法

前瞻性收集了2010年11月至2014年6月期间接受148例初次全髋关节置换术(THA)的138例患者的数据,使用的是保守型短柄假体。该队列分为2组:研究组(第1组)包括57例患者(60例THA),手术时年龄超过70岁,平均年龄75.4岁(范围70 - 87岁),平均随访26.7个月(范围9 - 48个月)。对照组(第2组)包括81例患者(88例THA),年龄小于70岁,平均年龄57.4岁(范围33 - 69岁),平均随访27.3个月(范围9 - 54个月)。使用Merle D'Aubigne髋关节评分(MD)和西安大略和麦克马斯特大学关节炎指数(WOMAC)评分在术前和术后比较两组的髋关节功能。

结果

在最近一次随访时,对照组中一名54岁患者报告发生1例股骨距骨折,需要用螺钉固定,结果良好。未报告临床或影像学松动病例。临床结果显示两组之间无统计学显著差异。

结论

在70岁以上患者中使用GTS保守型短柄假体已显示出非常好的效果和低并发症发生率,与70岁以下患者相当。

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