骨水泥与生物型假体半髋关节置换在治疗老年骨质疏松相关股骨颈骨折术后早期步态对比分析  

Early gait analysis of cemented and biologic prosthetic hemiarthroplasty for osteoporosis-related femoral neckfractures in the elderly

作　　者：邢宝瑞[1] 侯秀秀[1] 李运美[1] 韩波 Xing Baorui;Hou Xiuxiu;Li Yunmei;Han Bo(Department of Pelvic Hip Orthopedic Trauma,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou 061000,China)

机构地区：[1]河北省沧州中西医结合医院髋部创伤科,061000

出　　处：《骨科临床与研究杂志》2024年第3期183-188,共6页Journal Of Clinical Orthopedics And Research

摘　　要：目的运用步态分析技术比较骨水泥与生物型半髋假体在治疗老年骨质疏松相关股骨颈骨折术后早期不同时间段的步态变化,探讨两种假体植入术后早期的康复效果。方法通过分析2021年1月至2022年1月于河北省沧州中西医结合医院髋部创伤科半髋关节置换的患者资料,共60例;后外侧入路骨水泥假体半髋关节置换手术(30例),后外侧入路生物型假体半髋关节置换手术(30例)。采用步态分析技术比较每组患者术后1、3、6个月的行走时步长、步速、步频、行走时髋关节活动度的改善情况及两组患者之间的差异,以及两组患者术后1、3、6个月改良髋关节(MHHS)评分变化。结果两组患者的步长、步速、步频、髋关节外展活动度在术后3、6个月检测结果较术后1个月改善明显(P<0.05)。术后1、3个月时,骨水泥假体组患者的行走时步长、步频、步速、髋关节外展活动度检测结果优于生物型假体组(P<0.05);术后6个月时,两组各指标比较差异无统计学意义(P>0.05)。骨水泥型假体组与生物型假体组术后1、3、6个月的改良Harris评分差异无统计学意义(P>0.05)。但两组的术后3、6个月的MHHS评分均比术后1个月的评分要明显提升(P<0.05)。结论两种假体都可使骨质疏松老年股骨颈骨折获得明显的步态改善,但骨水泥型假体治疗老年骨质疏松相关股骨颈骨折可以早期促进患者髋关节功能的恢复和锻炼。Objective To compare the gait changes at different time periods between cemented and biotype semi-hip prosthesis for the treatment of osteoporosis-related femoral neck fractures in the elderly using gait analysis technique,and to explore the rehabilitation effects of the two prostheses in the early postoperative period after implantation.Methods 60 patients who were treated by hemi-hip in Department of Plevic Hip Orthopedic Trauma of Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2021 to January 2022 were analyzed retrospectively.The two groups of patients were hemi-hip replacement with bone cement prosthesis via posterolateral approach(n=30),posterolateral approach for hemi-hip replacement with biological prosthesis(n=30).The gait analysis technology was used to compare the improvement of walking time step length,gait speed,gait frequency and hip joint motion in each group 1,3 and 6 months after surgery,and the difference between the two groups,as well as the change of modified Harris score 1,3 and 6 months after surgery in the two groups.Results The results of stride length,stride speed,stride frequency and hip mobility during walking in both groups were significantly improved at 3 and 6 months postoperatively compared with 1 month postoperatively(P<0.05).The results of stride length,stride frequency,stride speed and hip mobility during walking in the cemented prosthesis group were better than those in the biologic prosthesis group at 1 and 3 months postoperatively(P<0.05);in 6 months postoperatively,there was no significant difference between the indexes of the two groups(P>0.05).There was no statistically significant difference in the modified Harris score between the cemented prosthesis group and the biologic prosthesis group in 1 month,3 months and 6 months postoperatively(P>0.05).However,the modified Harris scores at 3 months postoperatively and 6 months postoperatively were significantly higher than those at 1 month postoperatively in both groups,and the differences

关 键 词：关节成形术 置换 髋 假体和植入物 骨质疏松 老年人 骨水泥假体 生物型假体 

分 类 号：R683.4[医药卫生—骨科学]