Šponer Pavel, Kučera Tomáš, Grinac Michal, Bezrouk Aleš, Waciakowski Daniel
Department of Orthopaedic Surgery, Charles University in Prague, Faculty of Medicine in Hradec Králové, Šimkova 870, 500 38 Hradec Králové, Czech Republic.
Department of Orthopaedic Surgery, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic.
Parkinsons Dis. 2017;2017:1597463. doi: 10.1155/2017/1597463. Epub 2017 Sep 27.
The aim of the study was to compare the clinical outcomes following elective and traumatic total hip arthroplasty in Parkinson's disease patients.
Ten patients with osteoarthritis comprise the elective group (mean age at operation 74 years; mean follow-up 82 months). Thirteen patients with femoral fracture comprise the hip fracture group (mean age 76 years; mean follow-up 54 months). All patients were followed up at 6 and 36 months postoperatively and at the time of the latest follow-up.
Despite the significant improvement in Merle d'Aubigné-Postel and pain scores, disability related to Parkinson's disease increased during the follow-up. Whereas more than 1/3 of hip fracture patients and all elective patients walked independently at 36 months after total hip arthroplasty, 43% of living patients from both groups were able to walk independently at the time of the latest follow-up. The medical complications were seen mainly in patients with hip fracture.
Excellent pain relief with preserved walking ability without support of another person and acceptable complication profile was observed in Parkinson's disease patients at 36 months after elective total hip arthroplasty. This procedure may be indicated in Parkinson's disease patients after careful and individualized planning.
本研究的目的是比较帕金森病患者择期和创伤性全髋关节置换术后的临床结果。
10例骨关节炎患者组成择期手术组(平均手术年龄74岁;平均随访82个月)。13例股骨骨折患者组成髋部骨折组(平均年龄76岁;平均随访54个月)。所有患者在术后6个月、36个月以及最近一次随访时进行随访。
尽管Merle d'Aubigné-Postel评分和疼痛评分有显著改善,但在随访期间帕金森病相关残疾有所增加。全髋关节置换术后36个月时,超过1/3的髋部骨折患者和所有择期手术患者能够独立行走,而在最近一次随访时,两组中仍在世的患者中有43%能够独立行走。医疗并发症主要见于髋部骨折患者。
择期全髋关节置换术后36个月时,帕金森病患者疼痛得到显著缓解,无需他人帮助即可保持行走能力,并发症情况可接受。经过仔细的个体化规划后,该手术可能适用于帕金森病患者。