North Shore Hospital, Auckland, New Zealand.
Norfolk and Norwich University Hospital, Norwich, UK.
Bone Joint J. 2020 Jun;102-B(6):693-698. doi: 10.1302/0301-620X.102B6.BJJ-2019-1459.R1.
Despite few good-quality studies on the subject, total hip arthroplasty (THA) is increasingly being performed for displaced intracapsular fractures of the neck of femur. We compared outcomes of all patients with displacement of these fractures treated surgically over a ten-year period in one institution.
A total of 2,721 patients with intracapsular fractures of the femoral neck treated with either a cemented hemiarthroplasty or a THA at a single centre were retrospectively reviewed. The primary outcomes analyzed were readmission for any reason and revision surgery. We secondarily looked at mortality rates.
We found no difference in the overall revision rate or rate of infection. However, the rates of readmission due to dislocation, pain, and trochanteric bursitis were significantly higher in the THA group (p = 0.001, p < 0.001, p < 0.001, and p = 0.001, respectively).
Our study, comparing the outcomes of neck of femur fractures treated with a cemented hemiarthroplasty and THA, revealed the perceived superiority of THA was not borne out by our results. This should be carefully considered before any radical change in practice regarding the use of THA for displaced intracapsular fractures of the femoral neck. Cite this article: 2020;102-B(6):693-698.
尽管针对该主题的高质量研究较少，但全髋关节置换术（THA）越来越多地用于治疗股骨颈囊内移位骨折。我们比较了在一家机构中对这些骨折进行手术治疗的所有患者的结果。
回顾性分析了在一家中心接受骨水泥半髋关节置换术或 THA 治疗的 2721 例股骨颈囊内骨折患者。分析的主要结果为因任何原因再次入院和翻修手术。我们还观察了死亡率。
我们发现总体翻修率或感染率没有差异。但是，THA 组因脱位、疼痛和转子滑囊炎而再次入院的比率明显更高（p = 0.001，p < 0.001，p < 0.001 和 p = 0.001）。
我们比较了骨水泥半髋关节置换术和 THA 治疗股骨颈骨折的结果，发现 THA 的优势并未得到我们结果的证实。在考虑对使用 THA 治疗股骨颈囊内移位骨折的实践进行任何重大改变之前，应仔细考虑这一点。
2020;102-B(6)：693-698.
