Abstract:Objective: To study the effects of biotype long-stem hip replacement on perioperative indicators and postoperative recovery of elderly unstable intertrochanteric fractures. Methods: 248 patients with unstable intertrochanteric fractures treated in our hospital from April 2014 to April 2019 were selected and divided into two groups by simple random grouping, with 124 cases in each group. They were given bioprosthesis and bone cement prosthesis under intravenous inhalation general anesthesia or continuous epidural anesthesia respectively to perform hemi-hip replacement therapy. The perioperative indicators, prosthetic stability, postoperative hip function and complications were compared between the two groups. Results: The operative time and first ambulation time in biotype group were significantly lower than those in bone cement group (P<0.05), and there were no statistically significant differences in the intraoperative blood loss and hospital stay between the two groups (P>0.05). The prosthesis sinking distance in biotype group was significantly lower than that in bone cement group (P<0.05), and the incidence rates of prosthesis loosening in the two groups were 3.23% and 4.84% respectively (P>0.05). The Harris scores were significantly increased in the two groups (P<0.05), and the Harris scores at 1, 3, 6 and 12 months after surgery in biotype group were higher than those in bone cement group (P<0.05). The recovery effect of hip function in biotype group at 12 months after surgery was obviously better than that in bone cement group (P<0.05), and the excellent and good rates in the two groups were 72.58% and 54.84% (P<0.05). The incidence rates of postoperative infection and bone cement poisoning in biotype group were significantly lower than those in bone cement group (P<0.05), and the incidence rates of postoperative complications in the two groups were 11.29% and 28.23% (P<0.05), and the case fatality rates were 3.23% and 4.84% respectively(P>0.05). Conclusion: Biotype long-stem hip replacement for elderly patients with unstable intertrochanteric fractures is beneficial to shorten the operative time, promote postoperative rehabilitation, improve the stability of prosthesis and the recovery effect of hip function, and reduce the risk of postoperative complications.
[1] Prieto-Alhambra D,Reyes C,Sainz MS,et al.In-hospital care,complications,and 4-month mortality following a hip or proximal femur fracture: the Spanish registry of osteoporotic femur fractures prospective cohort study[J].Arch Osteoporos,2018,13(1):96. [2] Kim JY,Kong GM.Subcapital femoral neck fracture after treatment of an intertrochanteric fracture with proximal femoral intramedullary nail[J].Coll Physicians Surg Pak,2016,26(1):78~79. [3] 邓煜,夏于欣,白新文,等.生物型加长柄髋关节置换治疗老年不稳定性转子间骨折中股骨近端不同重建方法的疗效对比[J].中国组织工程研究,2019,23(12):1805~1811. [4] Hao LS,Guan T,Huang F,et al.Finite element analysis of InterTan for the treatment of femoral intertrochanteric fractures.[J].Zhongguo Gu Shang,2019,32(2):176~180. [5] Houdek MT,Wyles CC,Labott JR,et al.Durability of hemiarthroplasty for pathologic proximal femur fractures[J].Arthroplasty,2017,32(12):3607~3610. [6] 李真,饶仁林,骆浩,等.半髋关节置换术治疗高龄不稳定股骨转子间骨折中的假体选择[J].创伤外科杂志,2019,21(6):475~476. [7] 李伟伟,弓立群,刘军,等.半髋关节置换术不同假体对高龄不稳定骨质疏松性股骨转子间骨折患者预后的影响[J].中华创伤杂志,2018,34(7):580~584. [8] Knobe M,Nagel P,Maier KJ,et a1.Rotationally stable screw- anchor with locked troehanteric stabilizing plate versus proximal femoral nail antirotation in the treatment of AO/OTA 31A2.2 fracture:a biomechanieal evaluation[J].Orthop Trauma,2016,30(1):e12~e18. [9] Santori N,Falez F,Potestio D,Santori FS.Fourteen-year experience with short cemented stems in total hip replacement[J].Int Orthop,2019,43(1):55~61. [10] 罗明,易成腊,冯震中,等.两种不同加长柄人工髋关节置换术在高龄不稳定股骨转子间骨折中的应用对比[J].中国临床研究,2018,31(4):16~20. [11] 周霖.丙烯酸基骨水泥的临床应用新进展[J].生物医学工程与临床,2018,22(5):122~125.