The Hip Arthroplasty Unit, Trauma and Orthopaedics, Royal Gwent Hospital, Newport, Wales, United Kingdom.
J Arthroplasty. 2018 Dec;33(12):3719-3723. doi: 10.1016/j.arth.2018.08.014. Epub 2018 Aug 20.
The aim of this prospective cohort study is to evaluate the outcome of octogenarian patients undergoing uncemented total hip arthroplasty (THA) with a control group of similarly aged patients undergoing hybrid THA with a minimum 5-year follow-up.
Clinical outcomes including intraoperative and postoperative complications, blood transfusion, revision rate, and mortality were recorded. Radiological analysis of preoperative and postoperative radiographs assessed bone quality, implant fixation, and any subsequent loosening.
One hundred forty-three patients (mean age 86.2 years) were enrolled in the study. Seventy-six patients underwent uncemented THA and 67 underwent hybrid THA. The uncemented cohort had a significantly lower intraoperative complication rate (P = .017) and also a lower transfusion rate (P = .002). Mean hospital stay (P = .27) was comparable between the 2 groups. Two patients underwent revision surgery in each cohort.
Our study demonstrates that uncemented THA is safe for the octogenarian patient and we recommend that age should not be a barrier to the choice of implant. However, intraoperative assessment of bone quality should guide surgeons to the optimum decision regarding uncemented and hybrid implants.
本前瞻性队列研究旨在评估接受非骨水泥全髋关节置换术(THA)的 80 岁以上患者的治疗效果,并与接受最小 5 年随访的类似年龄混合 THA 患者的对照组进行比较。
记录术中及术后并发症、输血、翻修率和死亡率等临床结果。对术前和术后 X 线片进行影像学分析,评估骨质量、植入物固定情况以及任何后续的松动情况。
本研究共纳入 143 例患者(平均年龄 86.2 岁)。其中 76 例接受非骨水泥 THA,67 例接受混合 THA。非骨水泥组的术中并发症发生率明显较低(P=.017),输血率也较低(P=.002)。两组的平均住院时间(P=.27)相当。每个队列中有 2 例患者接受了翻修手术。
我们的研究表明,非骨水泥 THA 对 80 岁以上患者是安全的,我们建议年龄不应成为选择植入物的障碍。然而,术中骨质量的评估应指导外科医生做出关于非骨水泥和混合植入物的最佳决策。
3 级。