Department of Orthopedics & Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Orthopedics, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2019 May;82(5):419-423. doi: 10.1097/JCMA.0000000000000075.
The aim of this study was to evaluate the influence of leg length discrepancy in geriatric patients with early failure of bipolar hemiarthroplasty and to identify related failure patterns and risk factors.
In this retrospective study, the risk factors of early acetabulum failure within 5 years of hemiarthroplasty for displaced femoral neck fracture were compared with a control group of patients who had implant survival for at least 5 years after hemiarthroplasty. The basic data, leg length discrepancy, femoral offset, and the shell size were evaluated.
Of all risk factors, there was a significant difference in increased leg length between the two groups. The mean difference in leg length was 7.8 ± 5.9 mm in the early acetabular failure group and -1.7 ± 6.2 mm in the control group. For an increase in leg length of >6 mm, the odds ratio of early acetabular failure was 25-fold greater when compared with the control group.
Increased leg length was significantly associated with early acetabular failure after bipolar hemiarthroplasty for femoral neck fracture among geriatric patients. It is critical to avoid increase in leg length after bipolar hemiarthroplasty.
本研究旨在评估老年患者双极半髋关节置换术后早期失败与下肢长度差异的关系，并确定相关的失败模式和危险因素。
在这项回顾性研究中，我们比较了 5 年内因股骨颈骨折行双极半髋关节置换术早期髋臼失败的患者与至少 5 年假体存活的对照组患者的危险因素。评估了基本数据、下肢长度差异、股骨偏心距和外壳尺寸。
在所有的危险因素中，两组之间的下肢长度差异有显著差异。在早期髋臼失败组，下肢长度的平均差异为 7.8 ± 5.9mm，在对照组为-1.7 ± 6.2mm。与对照组相比，下肢长度增加>6mm 时，早期髋臼失败的优势比增加了 25 倍。
在老年股骨颈骨折患者中，双极半髋关节置换术后下肢长度的增加与早期髋臼失败显著相关。避免双极半髋关节置换术后下肢长度的增加至关重要。
