骨水泥单极或模块化双极半关节置换术治疗老年股骨颈骨折-哪个更好?

IF 1.4 Q3 EMERGENCY MEDICINE
International Journal of Burns and Trauma Pub Date : 2021-12-15 eCollection Date: 2021-01-01
Abdul Q Khan, Julfiqar Mohammad, Rayed Qamar, Yasir S Siddiqui, Aamir B Sabir, Mazhar Abbas
{"title":"骨水泥单极或模块化双极半关节置换术治疗老年股骨颈骨折-哪个更好?","authors":"Abdul Q Khan,&nbsp;Julfiqar Mohammad,&nbsp;Rayed Qamar,&nbsp;Yasir S Siddiqui,&nbsp;Aamir B Sabir,&nbsp;Mazhar Abbas","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Hemiarthroplasty is considered to be the treatment of choice for femoral neck fractures in elderly, however there is no consensus to support the choice between unipolar or bipolar hemiarthroplasty. Several studies found that patients with bipolar hemiarthroplasty had a better outcome of pain, a higher rate of return to the pre-injury state, and a greater range of hip motion. Some studies have demonstrated equal hip functional outcome between unipolar and bipolar hemiarthroplasty, but unipolar hemiarthroplasty was favoured due to its lower cost. The purpose of this study was to compare the functional and radiological outcome of cemented unipolar vs modular bipolar hemiarthroplasty in displaced femoral neck fracture in elderly patient population.</p><p><strong>Methods: </strong>It is a prospective randomized study, with 44 patients in each group. Elderly Patients (>60 years of age) with traumatic displaced femoral neck fractures were included in the study. Cemented unipolar or modular bipolar hemiarthroplasty was performed in the respective patient groups using posterior or anterolateral approach. Functional outcome evaluation was done by Harris Hip Score and radiological outcome evaluation was done for acetabular erosion. The data was entered in MS EXCEL spread sheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM, Chicago).</p><p><strong>Results: </strong>The mean age in the unipolar and bipolar group was 67.2 and 66.1 years respectively. The average follow-up period was 20.1 and 22.3 months in the unipolar and bipolar group respectively. Mean operating time was significantly more in the modular bipolar group (78.3 minutes) compared to the unipolar group (67.3 minutes). Two patients (4.5%) had acetabular erosion in each group. Mean Harris Hip score at 3 months follow-up was significantly higher (<i>p</i> value <0.05) in bipolar group (75.8±4.2) than the unipolar group (77.7±2.9). However, subsequent follow-ups at 6 months (80.9±2.8, 82.0±2.5, <i>p</i> value >0.05) 12 months (83.1±2.2, 83.2±1.2, <i>p</i> value >0.05) and 24 months (85.5±2.4, 85.2±2.8, <i>p</i> value >0.05) did not show any significant difference between the two groups. The incidence of general complications was 34% in bipolar and 20.4% in unipolar hemiarthroplasty group.</p><p><strong>Conclusion: </strong>Functional outcome in terms of Harris Hip Score are better in the bipolar group at 3 months follow up but there was no significant difference in the functional outcome between the two groups at 6, 12 and 24 months follow up. The operative time for unipolar is lower and statistically significant compared to bipolar hemiarthroplasty of the hip.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784747/pdf/ijbt0011-0447.pdf","citationCount":"0","resultStr":"{\"title\":\"Cemented unipolar or modular bipolar hemiarthroplasty for femoral neck fractures in elderly patients - which is better?\",\"authors\":\"Abdul Q Khan,&nbsp;Julfiqar Mohammad,&nbsp;Rayed Qamar,&nbsp;Yasir S Siddiqui,&nbsp;Aamir B Sabir,&nbsp;Mazhar Abbas\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Hemiarthroplasty is considered to be the treatment of choice for femoral neck fractures in elderly, however there is no consensus to support the choice between unipolar or bipolar hemiarthroplasty. Several studies found that patients with bipolar hemiarthroplasty had a better outcome of pain, a higher rate of return to the pre-injury state, and a greater range of hip motion. Some studies have demonstrated equal hip functional outcome between unipolar and bipolar hemiarthroplasty, but unipolar hemiarthroplasty was favoured due to its lower cost. The purpose of this study was to compare the functional and radiological outcome of cemented unipolar vs modular bipolar hemiarthroplasty in displaced femoral neck fracture in elderly patient population.</p><p><strong>Methods: </strong>It is a prospective randomized study, with 44 patients in each group. Elderly Patients (>60 years of age) with traumatic displaced femoral neck fractures were included in the study. Cemented unipolar or modular bipolar hemiarthroplasty was performed in the respective patient groups using posterior or anterolateral approach. Functional outcome evaluation was done by Harris Hip Score and radiological outcome evaluation was done for acetabular erosion. The data was entered in MS EXCEL spread sheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM, Chicago).</p><p><strong>Results: </strong>The mean age in the unipolar and bipolar group was 67.2 and 66.1 years respectively. The average follow-up period was 20.1 and 22.3 months in the unipolar and bipolar group respectively. Mean operating time was significantly more in the modular bipolar group (78.3 minutes) compared to the unipolar group (67.3 minutes). Two patients (4.5%) had acetabular erosion in each group. Mean Harris Hip score at 3 months follow-up was significantly higher (<i>p</i> value <0.05) in bipolar group (75.8±4.2) than the unipolar group (77.7±2.9). However, subsequent follow-ups at 6 months (80.9±2.8, 82.0±2.5, <i>p</i> value >0.05) 12 months (83.1±2.2, 83.2±1.2, <i>p</i> value >0.05) and 24 months (85.5±2.4, 85.2±2.8, <i>p</i> value >0.05) did not show any significant difference between the two groups. The incidence of general complications was 34% in bipolar and 20.4% in unipolar hemiarthroplasty group.</p><p><strong>Conclusion: </strong>Functional outcome in terms of Harris Hip Score are better in the bipolar group at 3 months follow up but there was no significant difference in the functional outcome between the two groups at 6, 12 and 24 months follow up. The operative time for unipolar is lower and statistically significant compared to bipolar hemiarthroplasty of the hip.</p>\",\"PeriodicalId\":45488,\"journal\":{\"name\":\"International Journal of Burns and Trauma\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2021-12-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784747/pdf/ijbt0011-0447.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Burns and Trauma\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Burns and Trauma","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0

摘要

引言:半关节置换术被认为是老年人股骨颈骨折的首选治疗方法,但是在单极半关节置换术和双极半关节置换术之间的选择尚无共识。几项研究发现,双相半关节置换术患者的疼痛效果更好,恢复到损伤前状态的比率更高,髋关节活动范围更大。一些研究表明,单极半关节置换术和双极半关节置换术的髋关节功能结果相同,但单极半关节置换术因其较低的成本而受到青睐。本研究的目的是比较骨水泥单极半关节置换术与模块化双极半关节置换术治疗老年移位性股骨颈骨折的功能和影像学结果。方法:采用前瞻性随机研究,每组44例。老年外伤性股骨颈移位骨折患者(>60岁)被纳入研究。分别采用后路或前外侧入路对患者组进行骨水泥单极或模块化双极半关节置换术。用Harris髋关节评分评估功能结果,对髋臼糜烂进行放射学结果评估。数据输入到MS EXCEL电子表格中,使用SPSS 20.0版本(IBM,芝加哥)进行分析。结果:单极组和双相组的平均年龄分别为67.2岁和66.1岁。单极和双相组的平均随访时间分别为20.1个月和22.3个月。模块化双相组的平均手术时间(78.3分钟)明显多于单极组(67.3分钟)。两组均有2例(4.5%)发生髋臼糜烂。随访3个月Harris髋关节平均评分显著增高(p值p值>0.05),12个月(83.1±2.2,83.2±1.2,p值>0.05),24个月(85.5±2.4,85.2±2.8,p值>0.05),两组间差异无统计学意义。双极半关节置换术组一般并发症发生率为34%,单极半关节置换术组为20.4%。结论:双相情感障碍组在随访3个月时Harris髋关节评分的功能结局较好,但在随访6、12、24个月时两组功能结局无显著差异。与双极半髋关节置换术相比,单极半髋关节置换术的手术时间更短,具有统计学意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Cemented unipolar or modular bipolar hemiarthroplasty for femoral neck fractures in elderly patients - which is better?

Cemented unipolar or modular bipolar hemiarthroplasty for femoral neck fractures in elderly patients - which is better?

Cemented unipolar or modular bipolar hemiarthroplasty for femoral neck fractures in elderly patients - which is better?

Cemented unipolar or modular bipolar hemiarthroplasty for femoral neck fractures in elderly patients - which is better?

Introduction: Hemiarthroplasty is considered to be the treatment of choice for femoral neck fractures in elderly, however there is no consensus to support the choice between unipolar or bipolar hemiarthroplasty. Several studies found that patients with bipolar hemiarthroplasty had a better outcome of pain, a higher rate of return to the pre-injury state, and a greater range of hip motion. Some studies have demonstrated equal hip functional outcome between unipolar and bipolar hemiarthroplasty, but unipolar hemiarthroplasty was favoured due to its lower cost. The purpose of this study was to compare the functional and radiological outcome of cemented unipolar vs modular bipolar hemiarthroplasty in displaced femoral neck fracture in elderly patient population.

Methods: It is a prospective randomized study, with 44 patients in each group. Elderly Patients (>60 years of age) with traumatic displaced femoral neck fractures were included in the study. Cemented unipolar or modular bipolar hemiarthroplasty was performed in the respective patient groups using posterior or anterolateral approach. Functional outcome evaluation was done by Harris Hip Score and radiological outcome evaluation was done for acetabular erosion. The data was entered in MS EXCEL spread sheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0 (IBM, Chicago).

Results: The mean age in the unipolar and bipolar group was 67.2 and 66.1 years respectively. The average follow-up period was 20.1 and 22.3 months in the unipolar and bipolar group respectively. Mean operating time was significantly more in the modular bipolar group (78.3 minutes) compared to the unipolar group (67.3 minutes). Two patients (4.5%) had acetabular erosion in each group. Mean Harris Hip score at 3 months follow-up was significantly higher (p value <0.05) in bipolar group (75.8±4.2) than the unipolar group (77.7±2.9). However, subsequent follow-ups at 6 months (80.9±2.8, 82.0±2.5, p value >0.05) 12 months (83.1±2.2, 83.2±1.2, p value >0.05) and 24 months (85.5±2.4, 85.2±2.8, p value >0.05) did not show any significant difference between the two groups. The incidence of general complications was 34% in bipolar and 20.4% in unipolar hemiarthroplasty group.

Conclusion: Functional outcome in terms of Harris Hip Score are better in the bipolar group at 3 months follow up but there was no significant difference in the functional outcome between the two groups at 6, 12 and 24 months follow up. The operative time for unipolar is lower and statistically significant compared to bipolar hemiarthroplasty of the hip.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
12.50%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信