Department of Orthopaedic Surgery, Spaarne Gasthuis Hospital, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands.
Department of Orthopaedic Surgery, CORAL - Center for Orthopaedic Research Alkmaar, Noordwest Ziekenhuisgroep Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
Eur J Orthop Surg Traumatol. 2020 Jul;30(5):885-893. doi: 10.1007/s00590-020-02652-z. Epub 2020 Mar 7.
There remains disagreement about the use of cemented or uncemented total hip arthroplasty (THA) for patients with a displaced intracapsular femoral neck fracture (FNF). The aim of this study was to assess implant survival, mortality, and postoperative complication rates of uncemented THA for a displaced intracapsular FNF in a single center.
A cohort of 115 patients who received uncemented THAs for a displaced intracapsular FNF was retrospectively examined for implant survival in terms of revision and any reoperation, mortality, and postoperative complications.
The one- and five-year implant survival was 99.1% (95% confidence interval (CI) 97.3-100.9) and 97.8% (95% CI 94.7-100.9) for revision and 93.6% (95% CI 88.9-98.3) and 90.0% (95% CI 83.3-96.7) for any reoperation, respectively. Impaired mobility was significantly associated with lower implant survival (p = 0.01). The one, three, and 12 month mortality rates were 2.8% (95% CI 0-5.9), 3.7% (95% CI 0.2-7.2), and 5.6% (95% CI 1.3-9.9), respectively. Postoperative complication rate was 10% with 5% intra-operative fractures.
Contrary to earlier reports of results of uncemented THA for displaced FNF, the results of this study were comparable with those reported in the literature for cemented THA in displaced FNF with respect to implant survival, mortality, and complication rates. This indicates that uncemented THA could be a viable option for these patients. In future, the additional literature with a prospective design is needed to support and reinforce our conclusion.
对于移位型囊内股骨颈骨折(FNF)患者,使用骨水泥型或非骨水泥型全髋关节置换术(THA)仍存在争议。本研究旨在评估单中心采用非骨水泥型 THA 治疗移位型囊内 FNF 的假体生存率、死亡率和术后并发症发生率。
回顾性分析了 115 例接受非骨水泥型 THA 治疗移位型囊内 FNF 的患者,评估了假体生存率(包括翻修和任何再手术)、死亡率和术后并发症。
翻修和任何再手术的 1 年和 5 年假体生存率分别为 99.1%(95%置信区间 97.3-100.9)和 97.8%(95%置信区间 94.7-100.9),93.6%(95%置信区间 88.9-98.3)和 90.0%(95%置信区间 83.3-96.7)。活动受限与较低的假体生存率显著相关(p=0.01)。1 个月、3 个月和 12 个月的死亡率分别为 2.8%(95%置信区间 0-5.9)、3.7%(95%置信区间 0.2-7.2)和 5.6%(95%置信区间 1.3-9.9)。术后并发症发生率为 10%,其中 5%为术中骨折。
与早期非骨水泥型 THA 治疗移位 FNF 结果报告相比,本研究结果在假体生存率、死亡率和并发症发生率方面与骨水泥型 THA 治疗移位 FNF 的文献报告相似。这表明非骨水泥型 THA 可能是这些患者的一种可行选择。未来需要更多前瞻性设计的文献来支持和加强我们的结论。