全髋与半髋关节置换治疗老年移位型股骨颈骨折疗效对比的Meta分析  

Total hip arthroplasty versus hemiarthroplasty of displaced fractures of femoral neck in aged patients: A Meta-analysis

作　　者：王晓凯[1] 王可良[1] 张志成[2] 周猛[2] 胡力丰[3] 

机构地区：[1]天津市西青医院骨科,300380 [2]北京军区总医院全军创伤骨科研究所 [3]天津市第五中心医院

出　　处：《中国骨与关节损伤杂志》2013年第4期310-313,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的系统评价全髋关节置换术(THA)与半髋关节置换术(HA)治疗老年移位型股骨颈骨折(DFNF)的疗效。方法应用Review Manager 5.1.4.0统计分析软件对采用THA与HA治疗老年移位型DFNF的临床疗效进行Meta分析。结果共纳入8篇临床随机对照研究(RCT),共1 059例DFNF。THA与HA比较,术后4年内THA髋关节功能Harris评分均高于HA(P=0.03);术后5年内翻修率差异无统计学意义(P=0.97);术后脱位率差异无统计学意义(P>0.10),但在术后5年时THA会增加脱位风险;术后4年内感染率差异无统计学意义(P=0.42)。结论 THA治疗老年移位型股骨颈骨折与HA比较可明显提高患者术后的髋关节功能,减少疼痛,增加关节活动度。从临床疗效方面来看,若患者没有禁忌证,可以优先考虑THA。Objective To assess the efficacy of total hip arthroplasty （THA） versus bemiarthroplasty （HA） in the treatment of aged patients with a displaced femoral neck fracture （DFNF）. Methods A meta-analysia was performed for all included randomized controlled trials to compare total hip arthmplasty with hemiarthroplasty in treatment of aged patients with displaced femoral neck fracture. Data analysis was conducted with Review Manager 5.1.4.0, which the Cochranc collaboration offered. Results This Meta-analysis included eight randomized control trials （RCT） with a total 1059 patients. Comparing total hip arthroplasty with bemiarthroplasty, the hip function was better in THA in four years （P --0.03）. Revision rate within five years had no statistical difference between two groups （P =0.97）. Dislocation rate in short-term and long-term had no statistical differences between THA with HA（P 〉0.10）. But the risk of dislocation was greater in THA at the period of five year. Infection rate within four years had no statistical difference between two groups （P =0.42）. Conclusion Comparing with HA,THA may markedly enhance the hip function, improve the motion of hip and el/minate pain of the patients undergoing operation. We should prefer to THA ff patients have no contraindications.

关 键 词：移位型股骨颈骨折 全髋关节置换 半髋关节置换 老年 META分析 

分 类 号：R687.42[医药卫生—骨科学]