Hunag Jiaqiang, Xia Hong, Chen Yanliang, Liu Zhong, Chen Xiaoming, Wang Chao
First Department of Orthopedics, Central Hospital of Xiangtan City, Xiangtan Hunan 411100, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 May 28;44(5):555-561. doi: 10.11817/j.issn.1672-7347.2019.05.013.
To explore the effect of Parkinson's syndrome on the survival of prosthesis after primary hip arthroplasty in elderly patients with femoral neck fracture. Methods: A total of 81 elderly patients (81 hips) with femoral neck fracture and primary hip replacement surgery, who came from the Department of Orthopaedics, Central Hospital of Xiangtan City from January 1, 2009 to December 30, 2010, were retrospectively analyzed, including 36 males and 45 females. Sixteen patients with Parkinson's syndrome were selected as a Parkinson's syndrome group, and the other 65 patients were served as a control group. The survival status of the prosthesis was followed up to December 30, 2017 and it was compared between the 2 groups (average follow-up was 7.5 years). Results: During the follow-up period, 5 patients in the Parkinson's group underwent revision of the hip joint, and the reasons for revision were periprosthetic fracture in 4 patients and aseptic loosening in 1 patient, but there was no dislocation or infection. There were 7 cases of revision in the control group, including 1 case of infection, 4 cases of aseptic loosening, 1 case of periprosthetic fracture, and 1 case of dislocation. In the follow-up period, the revision rate was 31.2% in the Parkinson's group and 10.8% in the control group (P<0.05). Parkinsonism was a risk factor for hip revision (OR=3.77, 95% CI 1.12 to 3.15). The incidence of periprosthetic fractures in the Parkinson's group was significantly higher than that in the control group (P<0.05). There was no statistical difference in the revision of the hip joint because of aseptic loosening, infection, and dislocation between the 2 groups (P>0.05). Conclusion: During an average of 7.5 years of follow-up, the older patients in the Parkinson's syndrome group have higher prosthetic failure rates after primary hip arthroplasty than those in the control group. The periprosthetic fractures are the most common causes. The development of individualized surgical procedures, the implementation of step-by-step rehabilitative exercises, and the suitable protective measures, and the enhancement of drug management and anti-osteoporosis treatment for Parkinson's syndrome may have positive implications for improving the survival of prosthesis in such patients.
探讨帕金森综合征对老年股骨颈骨折患者初次髋关节置换术后假体存活的影响。方法：回顾性分析2009年1月1日至2010年12月30日在湘潭市中心医院骨科行初次髋关节置换手术的81例老年股骨颈骨折患者（81髋），其中男36例，女45例。选取16例帕金森综合征患者作为帕金森综合征组，其余65例患者作为对照组。随访至2017年12月30日，比较两组假体存活情况（平均随访7.5年）。结果：随访期间，帕金森组有5例患者行髋关节翻修术，翻修原因：假体周围骨折4例，无菌性松动1例，无脱位及感染病例。对照组有7例翻修，其中感染1例，无菌性松动4例，假体周围骨折1例，脱位1例。随访期间，帕金森组翻修率为31.2%，对照组为10.8%（P<0.05）。帕金森病是髋关节翻修的危险因素（OR=3.77，95%CI 1.12至3.15）。帕金森组假体周围骨折发生率显著高于对照组（P<0.05）。两组因无菌性松动、感染及脱位行髋关节翻修的差异无统计学意义（P>0.05）。结论：平均随访7.5年，帕金森综合征组老年患者初次髋关节置换术后假体失败率高于对照组。假体周围骨折是最常见原因。制定个体化手术方案，实施循序渐进的康复锻炼及合适的保护措施，加强帕金森综合征的药物管理及抗骨质疏松治疗，可能对提高此类患者假体存活率有积极意义。
