Chinese Journal of Tissue Engineering Research ›› 2017, Vol. 21 ›› Issue (15): 2320-2324.doi: 10.3969/j.issn.2095-4344.2017.15.005

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Comparison of two kinds of femoral prosthesis for femoral neck fractures in hemiarthroplasty

Li Guo-wei, Guo Yuan-qing, Chen Tao, Zhang Kui-bo, Zhang Da-wei, Yu Bing, Zhang Rong-kai   

  1. Department of Spine Surgery, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519001, Guangdong Province, China
  • Online:2017-05-28 Published:2017-06-07
  • Contact: Zhang Rong-kai, Associate chief physician, Department of Spine Surgery, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519001, Guangdong Province, China
  • About author:Li Guo-wei, Master, Attending physician, Department of Spine Surgery, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519001, Guangdong Province, China

Abstract:

BACKGROUND: Studies have shown that hemiarthroplasty is suitable for single femoral head diseases with normal acetabulum. But indications for choosing bone cement or biological fixation types, short- and long-term efficacy as well as the complications have not yet reached agreement.

OBJECTIVE: To discuss the efficacy of two kinds of femoral prosthesis for femoral neck fractures in hemiarthroplasty, and the application of three-dimensional CT reconstruction in displaced fractures.
METHODS: Clinical data of 73 cases of femoral head fractures undergoing hemiarthroplasty were analyzed retrospectively, and divided into bone cement and biological groups. All patients were followed up for 1.5 years, and the operation indexes, hospitalization time and hip joint function were compared; the consistent degree with intraoperative findings was compared through hip three-dimensional CT and X-ray examination simultaneously.
RESULTS AND CONCLUSION: (1) There was no significant difference in the effective rate between groups (P > 0.05). (2) The operation time in the biological group was significantly shorter than that in the bone cement group (P < 0.05); the intraoperative blood loss and hospitalization time in the bone cement group were significantly less than those in the biological group (P < 0.05). (3) The Harris scores in the bone cement group were significantly higher than those in the biological group at 1 month after replacement (P < 0.05); the Harris scores in the biological group were significantly higher than those in the bone cement group at 18 months after replacement (P < 0.05); while there were no significant differences between two groups at 3, 6 and 12 months after replacement. (4) The hip three-dimensional reconstruction and X-ray examination showed no error compared with the intraoperative findings, reaching 100%. (5) Our findings suggest that age, disease history and bone quality should be considered when choosing an appropriate type of hemiarthroplasty for the patients with femoral neck fractures, and bone cement prosthesis is suitable for the elder patients with severe osteoporosis; while those with good bone quality should receive biological prosthesis. Besides, the diagnosis accuracy of three-dimensional reconstruction is superior to X-ray examination, which is conductive to fully understand displaced fractures.
 
中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Femoral Neck Fractures, Arthroplasty, Replacement, Hip, Polymethyl Methacrylate, Tissue Engineering

CLC Number: