Biotype and bone cement-type artificial femoral head replacement for the treatment of femoral neck fracture in elderly patients

doi:10.3969/j.issn.2095-4344.2013.26.003

Abstract

Abstract:

BACKGROUND: With the maturity and development of artificial joint materials, processes and technology, artificial femoral head replacement has been widely used for the treatment of femoral neck fracture, especially the elderly patients with displaced femoral neck fracture.
OBJECTIVE: To observe the clinical efficacy of biotypes and cementless artificial femoral head replacement for the treatment of elderly femoral neck fracture combined with heart disease.
METHODS: Thirty-five elderly femoral neck fracture patients with heart disease treated in the Department of Orthopedic Center, Tianjin Nursing Home from January 2004 to December 2009 were selected, including 16 cases of coronary heart disease combined with angina pectoris, eight cases of myocardial infarction coronary heart disease, eight cases of asymptomatic coronary heart disease and three cases of ischemic cardiomyopathy and coronary heart disease. And 18 cases were treated with biotypes artificial femoral head replacement, 17 cases were treated with cementless artificial femoral head replacement.
RESULTS AND CONCLUSION: One of the 35 patients was dead in the surgery, other 34 cases were followed-up for 8 to 36 months. Three cases of complications occurred in surgery were belongs to cementless group, and one patient died during surgery, two cases had to drop in blood pressure and suffered from difficulty breathing in surgery, whose life characteristics returned to normal after efforts to save. In the follow-up process, part of the prosthesis implanted in the two cases of patients with severe osteoporosis appears sinking in the biotype group, the excellent rate of biotype group was 89%(16/18), and the cementless group was 94%(16/17). It suggests that biotype artificial femoral head replacement is suitable for the patients with severe heart disease, while the cementless artificial femoral head replacement is suitable for osteoporosis patients.

Key words: bone and joint implants, artificial prosthesis, biotype, cementless, femoral head replacement, complicated heart disease, femoral neck fracture

CLC Number:

R318

Shi Jian-guo, Qiu Nan-hai. Biotype and bone cement-type artificial femoral head replacement for the treatment of femoral neck fracture in elderly patients[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2013.26.003.

Figures/Tables 3

References

[1] Wang YM,Zhang TL,Yu JH. Zhonghua Guke Zazhi. 2000;20 (4): 204-206.王裕民,张铁良,于建华.全髋关节置换术及骨折内固定术治疗老年股骨颈骨折临床随访结果比较[J].中华骨科杂志,2000, 20(4): 204-206.

[2] Liu ZY,Qian R,Xiao SL,et al. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2011;15(26):4788-4790.刘振逾,钱锐,肖诗梁,等.骨水泥型人工双极股骨头置换治疗骨质疏松性股骨颈骨折[J].中国组织工程研究与临床康复,2011, 15(26):4788-4790.

[3] Wu XX,Yang LT,Zhang SH,et al. Zhongguo Jiaoxing Waike Zazhi. 2010;18(8):690-692.吴晓萱,杨路亭,张淑环,等.运动和饮食指导在关节置换围手术期血糖控制中的作用[J].中国矫形外科杂志,2010,18(8):690-692.

[4] Wang LJ,Pan Q,Wu FC,et al.Zhongguo Linchuang Shiyong Yixue.2008;2(6):104-105.王力军,潘琦,吴发财,等. 84例Ⅱ型糖尿病患者髋关节置换术前、术中和术后处理分析[J].中国临床实用医学,2008,2(6):104-105.

[5] Xu YS,Xia WG,Liu YW,et al.Zhongguo Gu yu Guanjie Shunshang Zazhi. 2008;23(2):167-168.徐玉生,夏卫革,刘跃文,等. 动态血糖监测在老年糖尿病患者髋关节置换手术时机选择中的意义[J].中国骨与关节损伤杂志, 2008,23(2):167-168.

[6] Chen M,Guo CJ,Huang HS,et al. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2010;14(48): 8937-8940.陈明,郭承军,黄和生,等.生物型人工全髋关节置换治疗髋关节骨关节炎的中期疗效评估[J].中国组织工程研究与临床康复,2010, 14(48):8937-8940.

[7] Ma J,Ning XM,Shao DH.Shandong Yiyao. 2010;50(3):66- 67.马俊,宁显明,邵大洪.全髋关节和人工股骨头置换术治疗高龄患者股骨颈骨折的临床效果比较[J].山东医药, 2010,50(3):66-67.

[8] Tidermark J, Ponzer S, Svensson O,et al. Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly. A randomised, controlled trial.J Bone Joint Surg Br. 2003;85(3):380-388.

[9] Wang D,Liu XF,Kou BL,et al. Gu yu Guanjie Shunshang Zazhi. 2004; 19(7):454-456.王东,刘新房,寇伯龙,等.人工股骨头置换与全髋关节置换治疗老年股骨颈骨折[J].骨与关节损伤杂志, 2004, 19(7):454-456.

[10] Tsumura H, Torisu T, Kaku N,et al. Five- to fifteen-year clinical results and the radiographic evaluation of acetabular changes after bipolar hip arthroplasty for femoral head osteonecrosis. J Arthroplasty. 2005;20(7):892-897.

[11] Yao QQ,Wang LM,Gui JC,et al. Zhongguo Gu yu Guanjie Shunshang Zazhi. 2007; 22(10): 808-810.姚庆强,王黎明,桂鉴超,等.人工髋关节置换术治疗高龄股骨颈骨折的临床研究[J].中国骨与关节损伤杂志, 2007, 22(10): 808-810.

[12] Shi JX,Lin QR,Fu XB,et al. Fujian Yike Daxue Xuebao. 2008; 42(5):444-446.施进兴,林其仁,傅小杯,等.人工股骨头置换与全髋关节置换治疗老年股骨颈骨折[J].福建医科大学学报,2008, 42(5):444- 446.

[13] Ye M,Fang ZC,Mei HQ. Linchuang he Shiyan Yixue Zazhi. 2008;7(5):52-53.叶茂,房振春,梅海强.人工股骨头及全髋关节置换术治疗老年人股骨颈骨折的比较研究[J].临床和实验医学杂志,2008,7(5): 52-53.

[14] Wu Z,Han YL. Zhongguo Yaowu yu Linchuang. 2008;8(3): 238-239.吴振,韩永亮.三种手术方式治疗高龄老年股骨颈骨折疗效分析[J].中国药物与临床,2008,8(3):238-239.

[15] Gong LQ,Jia PQ,Liu SZ. Shanxi Yixue Zazhi. 2005;34(6): 690-691.弓立群,贾蒲琴,刘时璋.人工股骨头置换与全髋关节置换治疗老年人股骨颈骨折的疗效比较[J]. 陕西医学杂志,2005,34(6): 690-691.

[16] Xu ZX,Liu Y,Liu JG,et al. Zhonghua Chuangshang Zazhi. 2001; 17(9):546-548.徐莘香,刘一,刘建国,等.假体置换治疗老年股骨颈头下型骨折的疗效比较[J].中华创伤杂志,2001,17(9):546-548.

[17] Huang GY,Hu JH,Gao XS. Zhonghua Laonian Yixue Zazhi. 1999;18(6):325.黄公怡,胡建华,高新生.老年人股骨颈骨折治疗原则与治疗方法的选择[J].中华老年医学杂志,1999,18(6): 325.

[18] Zhang BW,Zhong AX,Yang JY. Zhonghua Chuangshang Guke Zazhi. 2002;4(4):318-319.张秉文,中安秀,杨建业.骨水泥型人工股骨头假体治疗高龄股骨颈骨折[J].中华创伤骨科杂志,2002,4(4):318-319.

[19] Wu LD,Yan SG,He RX,et al. Zhonghua Chuangshang Guke Zazhi. 2004;6(1) :55-58.吴立东,严世贵,何荣新,等.全髋与半髋关节置换术治疗老年人股骨颈骨折结果比较[J].中华创伤骨科杂志,2004,6(1) :55-58.

[20] Ma J,Ning XM,Shao DH. Shandong Yiyao. 2010;50(3):66-67.马俊,宁显明,邵大洪.全髋关节和人工股骨头置换术治疗高龄患者股骨颈骨折的临床效果比较[J].山东医药, 2010,50(3):66-67.

[21] Wu JW,Wu YR,Lu SH,et al. Hebei Yixue. 2009;15(8):925-928.吴金伟,吴有荣,卢盛华,等.人工股骨头置换术和全髋关节置换术治疗老年股骨颈骨折的疗效观察[J].河北医学,2009,15(8): 925-928.

[22] Wang D,Liu XF,Kou BL,et al. Gu yu Guanjie Shunshang Zazhi. 2004;19(7):454-456.王东,刘新房,寇伯龙,等.人工股骨头置换与全髋关节置换治疗老年股骨颈骨折[J].骨与关节损伤杂志, 2004,19(7):454-456.

[23] Ravikumar KJ, Marsh G. Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur--13 year results of a prospective randomised study. Injury. 2000;31(10):793-797.

[24] Chen GD,Wang ZB,Chen JC,et al. Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2010;14(35): 6483-6486.陈广栋,王振斌,陈建常,等.全髋关节置换与人工股骨头置换治疗高龄患者股骨颈骨折有效性与安全性的Meta分析[J].中国组织工程研究与临床康复,2010,14(35):6483-6486.

[25] Lu B,Tang LJ,Cui TA,et al. Zhongguo Gu yu Guanjie Shunshang Zazhi. 2006;21(1):55-56.卢波,唐林俊,崔太安,等.老年股骨颈骨折全髋关节置换术的疗效分析[J].中国骨与关节损伤杂志, 2006, 21(1): 55-56.

[26] Liu JG,Chen HY,Jiang T,et al. Zhongguo Gu yu Guanjie Shunshang Zazhi. 2005; 20(10):652-654.刘建国,陈洪瑜,姜涛,等.全髋关节置换与内固定治疗股骨颈骨折临床疗效分析[J].中国骨与关节损伤杂志, 2005, 20(10): 652-654.

[27] Jackson M, Learmonth ID.The treatment of nonunion after intracapsular fracture of the proximal femur. Clin Orthop Relat Res. 2002;(399):119-128.

[28] Masson M, Parker MJ, Fleischer S. Internal fixation versus arthroplasty for intracapsular proximal femoral fractures in adults. Cochrane Database Syst Rev. 2003;(2):CD001708.

[29] Parker MJ, Handoll HH. Replacement arthroplasty versus internal fixation for extracapsular hip fractures in adults. Cochrane Database Syst Rev. 2006;(2):CD000086.

[30] Rogmark C, Johnell O. Orthopaedic treatment of displaced femoral neck fractures in elderly patients. Disabil Rehabil. 2005;27(18-19):1143-1149.

[31] He L,Wang PY. Zhonghua Chuangshang Guke Zazhi. 2004;6(9):992-994.

贺良,王满宜.安全治疗高龄骨折[J].中华创伤骨科杂志, 2004,6(9): 992- 994.

[32] Zhang XM. Fujian Yike Daxue Xuebao. 2005;39(1):87-88.张旭鸣. 高龄股骨转子间骨折的手术治疗及围手术期的处理[J].福建医科大学学报,2005,39(1):87-88.

[33] Keating JF, Grant A, Masson M,et al. Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty. Treatment of displaced intracapsular hip fractures in healthy older patients.J Bone Joint Surg Am. 2006;88(2):249-260.

[34] Goh SK, Samuel M, Su DH,et al. Meta-analysis comparing total hip arthroplasty with hemiarthroplasty in the treatment of displaced neck of femur fracture.J Arthroplasty. 2009;24(3): 400-406.

[35] Wei RS,Liu B,Zhang LY,et al. Linchuang Guke Zazhi. 2010; 13(3):297-298.魏尧森,刘斌,张立岩,等.双极人工股骨头置换治疗高龄股骨颈骨折[J].临床骨科杂志,2010,13(3):297-298.

[36] Mo J,Yang ZH,Wang DW. Zhongyi Zhenggu. 2008;20(8): 30-31.莫坚,杨志华,王大伟.骨水泥型双极人工股骨头置换术治疗高龄老年股骨颈骨折[J].中医正骨,2008,20(8):30-31.

[37] Li YK,Zhou LJ,Xu B,et al. Sichuang Yixue. 2008;29(3): 285-287.李永奎,周林军,许冰,等.全髋置换术和人工股骨头置换术治疗老年股骨颈骨折的疗效比较[J].四川医学,2008,29(3):285- 287.

[38] LeCroy CM, Rizzo M, Gunneson EE,et al. Free vascularized fibular bone grafting in the management of femoral neck nonunion in patients younger than fifty years.J Orthop Trauma. 2002;16(7):464-472.

[39] Zhang JG,Xiao X,Zhang TL. Zhonghua Guke Zazhi. 2006; 267(7):468-471.张建国,肖湘,张铁良.带旋髂深血管蒂髂骨瓣植骨治疗青壮年陈旧性股骨颈骨折[J].中华骨科杂志,2006,267(7):468-471.

[40] Lin P,Li ZR,Yang LF. Zhonghua Chuangshang Guke Zazhi. 2004;6(5):509-512.林朋,李子荣,杨连发.老年重度移位股骨颈骨折的人工关节类型的选择[J].中华创伤骨科杂志,2004,6(5):509-512.

[41] Yang X,Bai ZH,Zeng G,et al. Linchuang Guke Zazhi. 2010; 13(4):465.杨轩,白朝晖,曾光,等.长柄双极人工股骨头置换治疗高龄不稳定股骨转子间骨折[J].临床骨科杂志,2010,13(4):465.

[42] Jackson M, Learmonth ID.The treatment of nonunion after intracapsular fracture of the proximal femur.Clin Orthop Relat Res. 2002;(399):119-128.

[43] Rodríguez-Merchán EC. Displaced intracapsular hip fractures: hemiarthroplasty or total arthroplasty. Clin Orthop Relat Res. 2002;(399):72-77.

[44] Ravikumar KJ, Marsh G. Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur--13 year results of a prospective randomised study. Injury. 2000;31(10):793-797.

[45] Zhou ZL,Shen H,Ouyang L. Zhonghua Chuangshang Zazhi. 2005;21(9):660-663.周智良,申华,欧阳林.不同手术方式治疗老年移位性股骨颈骨折术后疗效分析[J].中华创伤杂志,2005,21(9):660-663.

[46] Coppen A, Bolander-Gouaille C.Treatment of depression: time to consider folic acid and vitamin B12. J Psychopharmacol. 2005;19(1):59-65.

[47] Bolognesi MP, Marchant MH Jr, Viens NA,et al. The impact of diabetes on perioperative patient outcomes after total hip and total knee arthroplasty in the United States. J Arthroplasty. 2008;23(6 Suppl 1):92-98.

[48] Zheng C,Qu YX,Zhao H,et al.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu. 2010;14(39):7234-7237.郑冲,瞿玉兴,赵洪,等. 大直径金属对金属全髋关节假体置换49髋随访分析[J].中国组织工程研究与临床康复,2010,14(39): 7234-7237.

[49] Marchant MH Jr, Viens NA, Cook C,et al.The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty.J Bone Joint Surg Am. 2009;91(7):1621-1629.

[50] Wu XX,Yang LT,Zhang SH,et al.Zhongguo Jiaoxing Waike Zazhi. 2010;18(8):690-692.吴晓萱,杨路亭,张淑环,等.运动和饮食指导在关节置换围手术期血糖控制中的作用[J].中国矫形外科杂志,2010,18(8):690-692.