背景:近年来,无骨水泥短柄全髋关节置换术(THA)的适应症已经扩大到老年患者,因为他们也可能受益于短弯曲植入物设计的优势.因此,本研究旨在评估老年患者(≥75岁)与年轻对照组(≤60岁)的临床和放射学结局.
方法:对2014年至2017年间进行的316个THA的回顾性队列进行了前瞻性检查。在所有患者中,无水泥,弯曲的短杆和压合杯(Fitmore®杆;Allofit®/-S杯;ZimmerBiomet,华沙,IN,美国)通过微创前外侧入路植入。评估临床和放射学结果以及并发症和翻修率。
结果:总计,已纳入292例患者的并发症和修订分析(Ø随访:4.5年)和208例患者的临床和放射学结果(Ø随访:4.4年)。老年患者并发症发生率显著增加(13.7%vs.5.8%,p=0.023),而修订率增加无统计学意义(5.2%vs.2.2%,p=0.169)。老年患者的假体周围骨折发生率明显较高(5.2%vs.0.7%;p=0.026)。两组在Harris髋关节评分(93.7vs.91.9;p=0.224),牛津髋关节得分(44.5vs.43.7;p=0.350),被遗忘的联合得分(81.7vs.81.5;p=0.952)和WOMAC(7.4与9.3;p=0.334)。
结论:在75岁以上的患者中,与60岁以下的年轻患者相比,无水泥短柄全髋关节置换术显示出相当的临床和放射学结果。然而,无骨水泥短裤茎THA显示75岁以上老年患者的总体并发症和假体周围骨折发生率增加。75岁以上的患者应考虑股骨组件的胶结固定。
方法:III病例对照研究。
背景:由于ICMJE标准,无需试验注册的观察性研究。
BACKGROUND: In recent years, the indication for cementless short stem total hip arthroplasty (THA) has been widened to elderly patients as they might profit by the advantages of the short-curved implant design as well. Therefore, this study was conducted to evaluate the clinical and radiological outcome of a cementless short stem in elderly patients (≥ 75 years) compared to a young control group (≤ 60 years).
METHODS: A retrospective cohort of 316 THAs performed between 2014 and 2017 was prospectively examined. In all patients a cementless, curved short stem and press-fit cup (Fitmore® stem; Allofit®/-S cup; both ZimmerBiomet, Warsaw, IN, USA) were implanted via a minimally-invasive anterolateral approach. Clinical and radiological outcome as well as rate of complications and revision were assessed.
RESULTS: In total, 292 patients have been included for analysis of complications and revisions (Øfollow-up: 4.5 years) and 208 patients for clinical and radiological outcome (Øfollow-up: 4.4 years). Complication rate was significantly increased in elderly patients (13.7% vs. 5.8%, p = 0.023), while the revision rate was increased without statistical significance (5.2% vs. 2.2%, p = 0.169). Periprosthetic fractures occurred significantly higher in the elderly patients (5.2% vs. 0.7%; p = 0.026). Both groups showed a comparable clinical outcome in the Harris Hip Score (93.7 vs. 91.9; p = 0.224), Oxford Hip Score (44.5 vs. 43.7; p = 0.350), Forgotten Joint Score (81.7 vs. 81.5; p = 0.952) and WOMAC (7.4 vs. 9.3; p = 0.334).
CONCLUSIONS: Cementless short stem total hip arthroplasty shows a comparable clinical and radiological outcome in patients over 75 years of age compared to younger patients under 60 years of age. However, cementless shorts stem THA shows an increased rate of overall complications and periprosthetic fractures in elderly patients over 75 years of age. Cemented fixation of the femoral component should be considered in patients over 75 years of age.
METHODS: III Case-controlled study.
BACKGROUND: Observational study without need for trial registration due to ICMJE criteria.