中东人群中使用双动杯治疗股骨颈骨折的全髋关节置换术的死亡率和中期结果。
Mortality Rate and Mid-Term Outcomes of Total Hip Arthroplasty Using Dual Mobility Cups for the Treatment of Femoral Neck Fractures in a Middle Eastern Population.
机构信息
Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon.
Department of Anesthesiology, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon.
出版信息
J Arthroplasty. 2019 Feb;34(2):333-337. doi: 10.1016/j.arth.2018.10.030. Epub 2018 Nov 1.
BACKGROUND
The dual mobility cups (DMCs) were shown to reduce dislocation rate following total hip arthroplasty for any etiology, including femoral neck fractures. No reported studies evaluating DMC results for femoral neck fracture in a Middle Eastern population were found in the literature.
METHODS
This study aims to look for mortality rate, clinical, and functional outcomes in a population having specific rituals involving extreme hip positions as part of their daily activities.
RESULTS
Of an initial sample of 174 patients (177 operated hips), 18 (10.3%) patients (20 hips) died after a mean of 39.6 ± 13.8 months (ranging from 2 to 49 months) with only 3 (1.7%) during the first post-operative year. Twelve patients (13 hips) were lost to follow-up and 19 patients (19 hips) had their radiological data incomplete. In the final sample of 125 patients (125 hips), no dislocation, aseptic loosening, or infection was encountered. The mean modified Hip Harris Score was of 94.8 ± 8.4. The mean modified Hip Harris Score of 40 patients who used to practice regularly oriental sitting position or prayers was 94.1 ± 3.1. After surgery, 36 of these 40 patients (90%) described their hip as "a forgotten hip." Multivariate analyses found correlation only between mortality and cardiovascular co-morbidities.
CONCLUSION
DMC implants showed excellent clinical and functional results. The majority of patients having rituals and customs involving extreme hip positions were able to resume their daily activities. The observed low mortality rate should incite future research to investigate its correlation with the use of DMCs.
背景
双动杯(DMC)被证明可降低任何病因(包括股骨颈骨折)全髋关节置换术后的脱位率。文献中未发现评估 DMC 用于中东人群股骨颈骨折结果的报道。
方法
本研究旨在寻找具有特定仪式的人群的死亡率、临床和功能结果,这些仪式涉及到他们日常活动中的极端髋关节位置。
结果
在最初的 174 名患者(177 个手术髋关节)中,有 18 名(10.3%)患者(20 个髋关节)在平均 39.6 ± 13.8 个月(2 至 49 个月)后死亡,只有 3 名(1.7%)在术后第一年死亡。12 名患者(13 个髋关节)失访,19 名患者(19 个髋关节)的影像学资料不完整。在最终的 125 名患者(125 个髋关节)中,未发生脱位、无菌性松动或感染。改良髋关节 Harris 评分的平均值为 94.8 ± 8.4。40 名经常练习东方坐姿或祈祷的患者的改良髋关节 Harris 评分平均值为 94.1 ± 3.1。手术后,这 40 名患者中有 36 名(90%)描述他们的髋关节“像被遗忘了一样”。多变量分析发现,只有死亡率与心血管合并症相关。
结论
DMC 植入物显示出出色的临床和功能结果。大多数有涉及极端髋关节位置的仪式和习俗的患者能够恢复他们的日常活动。观察到的低死亡率应促使未来的研究调查其与 DMC 使用的相关性。