Taheriazam Afshin, Saeidinia Amin
Department of Orthopedics Surgery, Tehran Medical Sciences Branch, Islamic Azad University, Tehran Mashhad University of Medical Sciences, Mashhad Medical Practitioner, Guilan University of Medical Sciences, Rasht, Iran.
Medicine (Baltimore). 2017 Oct;96(40):e8235. doi: 10.1097/MD.0000000000008235.
Purpose of this study was to evaluate the outcomes of patients underwent hemiarthroplasty for proximal femoral fracture converted to total hip arthroplasty (THA).A total of 138 patients from October 2009 till October 2014 had conversion of their failed hemiarthroplasties following a proximal femoral fracture to total hip arthroplasty (THA) in Erfan and Milad hospitals, Tehran. We performed a prospective analysis of the outcome of conversion surgery in patients with failed hemiarthroplasty. The patients had clinical evaluations at 1 month, 6 months, 1 year, and annually thereafter. We used Harris Hip Score (HHS) to evaluate the results of conversion procedure in terms of relief of groin pain and functional improvement.Dislocation occurred in 6 patients (4.34%). The mean period of follow-up was 42 months (range 36-60 months). HHS score improved from mean preoperative score of 44.93 ± 8.40 to 95.41 ± 2.27 at final follow-up. The survivorship analysis with revision of HHS score was 89.1%. Existence of infection (P = .038) and time of primary operation to being symptomatic (P = .009) can predict the postoperative pain significantly.THA is a safe option which can lead to good functional and short-term and mid-term outcomes; and patients should be informed of the possibility of incomplete relief of groin pain or other symptoms postoperatively.
本研究的目的是评估接受股骨近端骨折半髋关节置换术并转换为全髋关节置换术（THA）患者的治疗结果。2009年10月至2014年10月期间，德黑兰的埃尔凡医院和米拉德医院共有138例股骨近端骨折半髋关节置换术失败后转换为全髋关节置换术（THA）的患者。我们对半髋关节置换术失败患者的转换手术结果进行了前瞻性分析。患者在术后1个月、6个月、1年及此后每年进行临床评估。我们使用Harris髋关节评分（HHS）从腹股沟疼痛缓解和功能改善方面评估转换手术的结果。6例患者（4.34%）发生脱位。平均随访时间为42个月（范围36 - 60个月）。最终随访时，HHS评分从术前平均44.93±8.40分提高到95.41±2.27分。HHS评分修订后的生存率分析为89.1%。感染的存在（P = 0.038）和初次手术至出现症状的时间（P = 0.009）可显著预测术后疼痛。全髋关节置换术是一种安全的选择，可带来良好的功能以及短期和中期结果；应告知患者术后腹股沟疼痛或其他症状可能无法完全缓解。
