比较不同类型假体用于骨质疏松症的老年股骨颈骨折

doi:10.3877/cma.j.issn.1674-134X.2024.02.017

目的

对比骨质疏松症(OP)老年股骨颈骨折患者使用不同类型假体的效果。

方法

回顾性分析佛山市中医院收治的91例患者的临床资料，采用非骨水泥型股骨假体42例(非骨水泥组)、骨水泥型股骨假体者有49例(骨水泥组)。对比两组手术相关指标、患侧髋关节功能、并发症。计量资料采用t检验，计数资料采用卡方检验。

结果

骨水泥组术后下地时间和术后完全负重时间均短于非骨水泥组(t＝9.484、3.646，均为P<0.05)；骨水泥组术后髋关节功能评分均高于非骨水泥组(t＝7.626、6.891，均为P<0.05)；骨水泥组并发症发生率低于非骨水泥组(校正χ²＝4.623，P<0.05)。

结论

对老年伴OP的股骨颈骨折患者采用骨水泥型股骨假体进行髋关节置换较非骨水泥型股骨假体更具优势。

关键词: 骨质疏松, 股骨颈骨折, 关节成形术，置换，髋

Objective

To compare the application effect of cementless femoral prosthesis and cemented femoral prosthesis in hip replacement for femoral neck fracture of elderly patients with osteoporosis (OP).

Methods

The clinical data of 91 elderly patients with femoral neck fracture with OP from Foshan Hospital of Traditional Chinese Medicine were retrospectively analyzed. They were all treated with hip replacement, and 42 cases were treated with non cemented femoral prosthesis (the non-cemented group) and 49 cases were treated with cemented femoral prosthesis (the cemented group). The operation related indexes, hip function of affected side and complications were compared between the two groups. Measurement data were analyzed using t tests, while count data were analyzed using chi square tests.

Results

The ambulance time and full weight-bearing in the cemented group was shorter than the non-cemented group (t=9.484, 3.646, both P <0.05). The hip function scores of the cemented group after operation were higher than those in the non-cemented group (t=7.626, 6.891, both P<0.05). The incidence of complications in the cemented group was lower than that in the non-cemented group (corrected χ²=4.623, P<0.05).

Conclusion

The use of bone cement femoral prosthesis for hip replacement is more advantageous than non bone cement femoral prosthesis for elderly patients with femoral neck fracture accompanied by OP.

Key words: Osteoporosis, Femoral neck fracture, Arthroplasty, replacement, hip

表1 两组手术相关指标对比(

±s)

Table 1 Comparison of surgical related indicators between two groups

组别Groups	例数Case number	手术持续时间(min)Duration of surgery	术中出血量(ml)Intra-operation blood loss	术后下地时间(d)Ambulance time	术后完全负重时间(d)Full weight-bearing time after operation
非骨水泥组Non-cemented group	42	60.1±9.9	222.6±35.4	3.2±1.0	29.3±4.6
骨水泥组Cemented group	49	63.2±10.0	231.8±41.1	1.6±0.6	26.8±1.2
t值		1.458	1.126	9.484	3.646
P值		>0.05	>0.05	<0.05	<0.001

表1 两组手术相关指标对比(

±s)

Table 1 Comparison of surgical related indicators between two groups

组别Groups	例数Case number	手术持续时间(min)Duration of surgery	术中出血量(ml)Intra-operation blood loss	术后下地时间(d)Ambulance time	术后完全负重时间(d)Full weight-bearing time after operation
非骨水泥组Non-cemented group	42	60.1±9.9	222.6±35.4	3.2±1.0	29.3±4.6
骨水泥组Cemented group	49	63.2±10.0	231.8±41.1	1.6±0.6	26.8±1.2
t值		1.458	1.126	9.484	3.646
P值		>0.05	>0.05	<0.05	<0.001

表2 两组患侧髋关节功能对比(

±s)

Table 2 Function comparison of on the affected hip joint between two groups

组别Groups	例数Case number	术前Before operation	术后3个月Three months after operation	术后6个月Six months after operation	F值	P值
非骨水泥组Non-cemented group	42	31±5	68±8^a	81±9^ab	534.366	<0.001
骨水泥组Cemented group	49	31±5	75±8^a	87±9^ab	730.108	<0.001
t值		0.300	7.626	6.891
P值		>0.05	<0.001	<0.001

表2 两组患侧髋关节功能对比(

±s)

Table 2 Function comparison of on the affected hip joint between two groups

组别Groups	例数Case number	术前Before operation	术后3个月Three months after operation	术后6个月Six months after operation	F值	P值
非骨水泥组Non-cemented group	42	31±5	68±8^a	81±9^ab	534.366	<0.001
骨水泥组Cemented group	49	31±5	75±8^a	87±9^ab	730.108	<0.001
t值		0.300	7.626	6.891
P值		>0.05	<0.001	<0.001

[1]	张立海. 老年骨质疏松骨折的现状和挑战[J]. 中华老年多器官疾病杂志，2020, 19(7): 481－484.
[2]	黄永湘，李宝林，唐爱民，等. 老年股骨颈骨折患者使用骨水泥型和生物型假体行股骨头置换术的疗效对比[J]. 创伤外科杂志，2020, 22(2): 151－152.
[3]	Mercier Lonnie R.原著//戴闽，姚浩群主译. 实用骨科学精要[M]. 6版. 北京：人民军医出版社，2016: 178－182.
[4]	Jørgensen PB, Lamm M, Søballe K, et al. Equivalent hip stem fixation by Hi-Fatigue G and Palacos R＋G bone cement: a randomized radiostereometric controlled trial of 52 patients with 2 years′ follow-up[J]. Acta Orthop, 2019, 90(3): 237－242.
[5]	Scanelli JA, Reiser GR, Sloboda JF, et al. Cemented femoral component use in hip arthroplasty[J]. J Am Acad Orthop Surg, 2019, 27(4): 119－127.
[6]	思玉楼，刘娥，杨涛. 老年股骨颈骨折双侧同期非骨水泥型与骨水泥型人工全髋关节置换术临床疗效比较[J]. 医学临床研究，2018, 35(1): 52－55.
[7]	浦飞飞，张志才，邵增务，等. 骨水泥型与非骨水泥型假体置换治疗膝关节周围骨肉瘤的疗效评价[J]. 中国骨与关节杂志，2021, 10(2): 107－110.
[8]	Hines CB, Collins-Yoder A. Bone cement implantation syndrome: key concepts for perioperative nurses[J]. AORN J, 2019, 109(2): 202－216.
[9]	Pritchett J. Large diameter total hip replacement for acute displaced femoral neck fracture[J]. J Long Term Eff Med Implants, 2019, 29(1): 71－78.

[1]	蒲彦婷, 吴翠先, 兰玉梅. 类风湿关节炎患者骨质疏松症风险预测列线图模型构建[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 596-603.
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[6]	黄韬, 杨晓华, 薛天森, 肖睿. 改良“蛋壳”技术治疗老年OVCF及对脊柱矢状面平衡参数、预后的影响[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 340-348.
[7]	谭明明, 战世强, 侯宏涛, 曾翔硕. 经皮微创椎弓根螺钉内固定术对骨质疏松脊柱压缩性骨折患者临床研究[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 349-354.
[8]	王芳, 刘达, 左智炜, 盛金平, 陈庭进, 蒋锐. 定量CT与双能X线骨密度仪对骨质疏松诊断效能比较的Meta分析[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 363-371.
[9]	张于, 程亮亮, 王峰, 赵德伟. 2枚与3枚空心钉治疗无移位股骨颈骨折的疗效对比[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(05): 281-286.
[10]	茹江英, 廖启宇, 温国洪, 潘思华, 刘栋, 张皓琛, 牛云飞. 直接前方入路和后外侧入路半髋关节置换治疗老年痴呆股骨颈骨折的疗效比较[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(05): 287-293.
[11]	单良, 刘怡, 于涛, 徐丽. 老年股骨颈骨折术后患者心理弹性现状及影响因素分析[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(05): 294-300.
[12]	周锐, 罗飞. 骨质疏松椎体骨折的分型进展[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(05): 315-320.
[13]	冯献礼, 高彤, 张喜善. 骨水泥注射量及弥散程度与PVP治疗OVCF的疗效分析[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(04): 193-201.
[14]	李彦霖, 王海程, 权元元, 张一凡, 陈伟. 腰椎骨小梁生物力学特性及其在骨质疏松骨折治疗中的应用[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(04): 243-250.
[15]	崔晓珊, 铁涛, 袁坤山, 孙钢, 张海军, 金鹏. 骨质疏松症及其椎体压缩骨折局部与全身一体化防治的动物实验研究[J/OL]. 中华介入放射学电子杂志, 2024, 12(04): 369-373.

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Comparison of different prostheses types in femoral neck fractures of elderly patients with osteoporosis

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