Department of Orthopedics, The First Clinical College, The First Affiliated Hospital, Jinan University, Guangzhou, 510632, China.
Int Orthop. 2022 Mar;46(3):489-496. doi: 10.1007/s00264-021-05222-y. Epub 2021 Sep 27.
Patients with poliomyelitis underwent total hip arthroplasty (THA) are known to be at higher risk of dislocation on account of muscular atrophy. This study aimed to investigate clinical outcomes, radiographic outcomes, complication rates, and survivorship of dual mobility THA in displaced femoral neck fractures of elderly with poliomyelitis.
We retrospectively included 17 patients (17 hips) with residual poliomyelitis who underwent THA with dual mobility articulation. Clinical outcomes were assessed with the visual analog scale (VAS) pain score, Oxford hip score, and University of California Los Angeles activity (UCLA) score. Radiographic outcomes were examined by radiographs. Complications and re-operations following THA were recorded.
The mean follow-up period was 77.05 months. The mean VAS, Oxford hip score, and UCLA score were improved significantly. In all but one patient, no complications were occurred. Re-operation was carried out in one patient due to posterior dislocation. The Kaplan-Meier survivorship with an end point of re-operation for any reason was 94.1%.
THA with dual mobility system is proved to be effective in strengthening stability and reducing the risk of dislocation, which is suitable for patients with neuromuscular disease. Hence, in elderly with residual poliomyelitis, dual mobility THA is a valid choice as a treatment for displaced femoral neck fractures.
患有小儿麻痹症的患者行全髋关节置换术(THA)时,由于肌肉萎缩,脱位的风险较高。本研究旨在探讨双动头THA 治疗老年小儿麻痹症股骨颈骨折移位的临床结果、影像学结果、并发症发生率和生存率。
我们回顾性纳入了 17 例(17 髋)患有小儿麻痹后遗症的患者,这些患者接受了双动关节的 THA。临床结果通过视觉模拟评分(VAS)疼痛评分、牛津髋关节评分和加利福尼亚大学洛杉矶活动(UCLA)评分进行评估。通过 X 线片检查影像学结果。记录 THA 后的并发症和再次手术情况。
平均随访时间为 77.05 个月。VAS、牛津髋关节评分和 UCLA 评分均显著改善。除 1 例患者外,无并发症发生。1 例患者因后脱位而行再次手术。因任何原因进行再次手术的 Kaplan-Meier 生存率为 94.1%。
双动系统 THA 被证明可以有效增强稳定性,降低脱位风险,适用于神经肌肉疾病患者。因此,对于患有小儿麻痹后遗症的老年患者,双动 THA 是治疗股骨颈骨折移位的有效选择。