Lo W H, Chen W M, Huang C K, Chen T H, Chiu F Y, Chen C M
Department of Orthopaedics and Traumatology, Taipei-Veterans General Hospital, Taiwan, Republic of China.
Clin Orthop Relat Res. 1994 May(302):75-82.
Four hundred forty-seven patients with 451 displaced fractures of the femoral neck were treated with Bateman bipolar hemiarthroplasty (190 cemented and 261 uncemented) between 1985 and 1990 in the authors' institution. During a follow-up period of at least two years, the authors found less thigh pain (13% versus 46.2%) and higher Harris hip scores (86 versus 79) in the cemented group in comparison with the uncemented group. Radiographic examination showed less radiolucent zones and subsidence in the cemented group. Heterotopic ossification was more common in the cemented group. Despite the fact that the cemented group had longer operative times (average, 20 minutes) and more blood loss (average, 160 ml) during the operation, there was no significant difference in the early mortality rate observed between these two groups. The cemented prostheses provided better functional and radiographic results and fewer failures in the early stage. In addition, the cemented prostheses did not lead to more complications and higher mortality rates. Thus, for elderly patients who need early ambulation and functional recovery, the cemented Bateman bipolar prosthesis appears to be a better choice than the uncemented Bateman prosthesis.
1985年至1990年间，作者所在机构对447例患有451处股骨颈移位骨折的患者进行了Bateman双极半髋关节置换术（190例使用骨水泥固定，261例未使用骨水泥固定）。在至少两年的随访期内，作者发现与未使用骨水泥固定的组相比，使用骨水泥固定的组大腿疼痛较少（13%对46.2%），Harris髋关节评分较高（86分对79分）。影像学检查显示，使用骨水泥固定的组透光线区和下沉较少。骨水泥固定组异位骨化更常见。尽管骨水泥固定组手术时间较长（平均20分钟），术中失血量较多（平均160毫升），但两组观察到的早期死亡率没有显著差异。骨水泥固定假体在早期提供了更好的功能和影像学结果，失败情况更少。此外，骨水泥固定假体不会导致更多并发症和更高死亡率。因此，对于需要早期活动和功能恢复的老年患者，骨水泥固定的Bateman双极假体似乎比未使用骨水泥固定的Bateman假体是更好的选择。
