Mahmoud Ahmed Nageeb, Ordas-Bayon Alejandro, Doyle Catherine Mary, Echeverry-Martinez Maria F, Horwitz Daniel S
Departamento de Cirurgia Ortopédica, Geisinger Medical Center, Danville, PA, Estados Unidos.
Departamento de Cirurgia Ortopédica, Ain Shams University, Cairo, Egito.
Rev Bras Ortop (Sao Paulo). 2025 Jan 16;60(1):1-8. doi: 10.1055/s-0044-1792099. eCollection 2025 Feb.
Femoral neck fractures in multiple myeloma patients are usually managed with hemiarthroplasty or total hip arthroplasty, depending on the presence of acetabular infiltration. Due to the paucity of dedicated studies, the aim of the present study is to review the clinical outcomes of hip hemiarthroplasty in patients with multiple myeloma and to review the literature regarding the outcomes and survival in these patients' subset. There were 15 patients (16 cases), with a mean age of 71.7 years, who had myeloma and received hip hemiarthroplasty for displaced femoral neck fractures had their radiographs and clinical data assessed for this study. From those, 13 cases received bipolar and 3 unipolar hemiarthroplasty. After a mean follow-up of 18.2 months since the time of surgery, 3 cases suffered periprosthetic fractures (18.75%), 4 cases (25%) had heterotopic ossification, and 1 case (6.25%) had acetabular erosion. The 1- and 5-year patient mortality rates for the study cohort were 53.3 and 73.3%, respectively. Hip hemiarthroplasty remains a viable treatment option in myeloma patients; however, the potentially high morbidity and mortality in these patients should be sensibly understood before the surgery to achieve satisfactory expectations.
多发性骨髓瘤患者的股骨颈骨折通常根据髋臼浸润情况采用半髋关节置换术或全髋关节置换术进行治疗。由于专门研究较少，本研究旨在回顾多发性骨髓瘤患者行半髋关节置换术的临床结果，并回顾有关该患者亚组的结果和生存情况的文献。本研究评估了15例（16髋）平均年龄为71.7岁的骨髓瘤患者因股骨颈移位骨折接受半髋关节置换术的X线片和临床资料。其中，13例接受双极半髋关节置换术，3例接受单极半髋关节置换术。自手术时间起平均随访18.2个月后，3例发生假体周围骨折（18.75%），4例（25%）发生异位骨化，1例（6.25%）发生髋臼侵蚀。该研究队列的1年和5年患者死亡率分别为53.3%和73.3%。半髋关节置换术仍是骨髓瘤患者可行的治疗选择；然而，在手术前应充分认识到这些患者潜在的高发病率和死亡率，以达到满意的预期。
