Short-term clinical efficacy of secondary total hip arthroplasty after failure of internal fixation <b><i>versus</i></b> primary total hip arthroplasty in elderly patients with displaced femoral neck fracture _West China Medical Journal

Authors：

SI Yan ¹ ,  HAN Jie ¹ , ZHANG Peng ¹ , ZHANG Shangshang ¹ , ZHU Jiangwei ¹ , LI Zhong ¹ , BI Mengna ¹ , CHEN Jingyong ¹ , LI Jian ²

1. Department of Geriatric Orthopedic, Sichuan Provincial Orthopedic Hospital, Chengdu, Sichuan 610041, P. R. China;
2. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HAN Jie, Email: hanjie5478@163.com

Keywords：

Elderly; Displaced femoral neck fracture; Total hip arthroplasty; Failure of internal fixation

DOI：

10.7507/1002-0179.201808027

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Objective To compare the short-term clinical outcomes of secondary total hip arthroplasty (THA) after failure of internal fixation with primary THA in elderly patients with displaced femoral neck fractures, and explore the best treatment for displaced femoral neck fractures in the elderly. Methods A total of 300 elderly patients with displaced femoral neck fractures from January 2011 to January 2015 were retrospectively enrolled in this study, of whom 150 underwent primary THA and 150 underwent secondary THA after failure of internal fixation. The operation time, intraoperative bleeding volume, postoperative drainage volume, postoperative ambulation time, length of postoperative hospitalization, incidence of postoperative complications, and score of postoperative hip joint function were compared between the two groups. Results Compared with those in the secondary THA group, in the primary THA group, the operation time was shorter [(54.7±15.3) vs. (70.1±23.4) minutes], the intraoperative bleeding volume was less [(116.9±35.0) vs. (131.7±44.5) mL], the postoperative ambulation was earlier [(1.0±0.3) vs. (1.8±0.6) days], the length of postoperative hospitalization was shorter [(12.0±2.9) vs. (15.2±3.1) days], and the differences were all statistically significant (P<0.05); but there was no statistically significant difference in the incidence of postoperative complications or the Harris scores at 3, 6, 12, and 24 months after operation (P>0.05). Conclusion The secondary THA for femoral neck fracture is more difficult, with longer stay in hospital, but the short-term clinical efficacy is similar to that of the primary THA.

Citation： SI Yan, HAN Jie, ZHANG Peng, ZHANG Shangshang, ZHU Jiangwei, LI Zhong, BI Mengna, CHEN Jingyong, LI Jian. Short-term clinical efficacy of secondary total hip arthroplasty after failure of internal fixation versus primary total hip arthroplasty in elderly patients with displaced femoral neck fracture . West China Medical Journal, 2018, 33(9): 1114-1117. doi: 10.7507/1002-0179.201808027 Copy

1.	王滿宜, 危杰. 股骨頸骨折臨床研究的若干問題與新概念. 中華創傷骨科雜志, 2003, 5(1): 5-9.
2.	Ismail AA, Pye SR, Cockerill WC, et al. Incidence of limb fracture across Europe: results from the European Prospective Osteoporosis Study (EPOS). Osteoporosis Int, 2002, 13(7): 565-571.
3.	Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis, 1987, 40(5): 373-383.
4.	王春利, 陶樹清, 曹德宇, 等. 老年移位型股骨頸骨折行髖關節置換術與內固定失效后再行髖關節置換術的療效對比. 中國醫師進修雜志, 2014, 37(11): 17-19.
5.	曾智敏, 何志勇, 陶崑, 等. 股骨頸骨折內固定失敗 Ⅱ 期行髖關節置換的早期療效. 中國骨傷, 2013, 26(7): 584-586.
6.	Yang Z, Liu H, Xie X, et al. Total hip arthroplasty for failed internal fixation after femoral neck fracture versus that for acute displaced femoral neck fracture: a comparative study. J Arthroplasty, 2015, 30(8): 1378-1383.
7.	Leonard HA, Liddle AD, Burke O, et al. Single-or two-stage revision for infected total hip arthroplasty? A systematic review of the literature. Clin Orthop Relat Res, 2014, 472(3): 1036-1042.
8.	Martin GR, Marsh JD, Vasarhelyi EM, et al. A cost analysis of single-stage bilateral versus two-stage direct anterior total hip arthroplasty. Hip Int, 2016, 26(1): 15-19.
9.	Wolf CF, Gu NY, Doctor JN, et al. Comparison of one and two-stage revision of total hip arthroplasty complicated by infection: a Markov expected-utility decision analysis. J Bone Joint Surg Am, 2011, 93(7): 631-639.
10.	薛慶云, 黃公怡, 高新生, 等. 439 例老年人髖部骨折的外傷因素分析. 中華老年醫學雜志, 1996, 15(4): 276-278.
11.	張化武, 王棟, 趙磊. 三種術式治療老年人股骨頸骨折療效對比觀察. 山東醫藥, 2010, 50(14): 48-49.
12.	Berger RA. The technique of minimally invasive total hip arthroplasty using the two-incision approach. Instr Course Lect, 2004, 53: 149-155.
13.	Attinger M, Siebenrock K. Total hip replacement: between normal rehabilitation and complication. Praxis (Bern 1994), 2014, 103(24): 1439-1446.
14.	周朝波. 人工髖關節置換術治療老年髖關節骨折內固定失敗的臨床研究. 現代中西醫結合雜志, 2015, 24(16): 1753-1755.
15.	傅余良, 趙隆隊, 朱琦, 等. 人工關節置換治療空心釘內固定失敗的股骨頸骨折. 江西醫學, 2013, 48(7): 589-590.

1. 王滿宜, 危杰. 股骨頸骨折臨床研究的若干問題與新概念. 中華創傷骨科雜志, 2003, 5(1): 5-9.
2. Ismail AA, Pye SR, Cockerill WC, et al. Incidence of limb fracture across Europe: results from the European Prospective Osteoporosis Study (EPOS). Osteoporosis Int, 2002, 13(7): 565-571.
3. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis, 1987, 40(5): 373-383.
4. 王春利, 陶樹清, 曹德宇, 等. 老年移位型股骨頸骨折行髖關節置換術與內固定失效后再行髖關節置換術的療效對比. 中國醫師進修雜志, 2014, 37(11): 17-19.
5. 曾智敏, 何志勇, 陶崑, 等. 股骨頸骨折內固定失敗 Ⅱ 期行髖關節置換的早期療效. 中國骨傷, 2013, 26(7): 584-586.
6. Yang Z, Liu H, Xie X, et al. Total hip arthroplasty for failed internal fixation after femoral neck fracture versus that for acute displaced femoral neck fracture: a comparative study. J Arthroplasty, 2015, 30(8): 1378-1383.
7. Leonard HA, Liddle AD, Burke O, et al. Single-or two-stage revision for infected total hip arthroplasty? A systematic review of the literature. Clin Orthop Relat Res, 2014, 472(3): 1036-1042.
8. Martin GR, Marsh JD, Vasarhelyi EM, et al. A cost analysis of single-stage bilateral versus two-stage direct anterior total hip arthroplasty. Hip Int, 2016, 26(1): 15-19.
9. Wolf CF, Gu NY, Doctor JN, et al. Comparison of one and two-stage revision of total hip arthroplasty complicated by infection: a Markov expected-utility decision analysis. J Bone Joint Surg Am, 2011, 93(7): 631-639.
10. 薛慶云, 黃公怡, 高新生, 等. 439 例老年人髖部骨折的外傷因素分析. 中華老年醫學雜志, 1996, 15(4): 276-278.
11. 張化武, 王棟, 趙磊. 三種術式治療老年人股骨頸骨折療效對比觀察. 山東醫藥, 2010, 50(14): 48-49.
12. Berger RA. The technique of minimally invasive total hip arthroplasty using the two-incision approach. Instr Course Lect, 2004, 53: 149-155.
13. Attinger M, Siebenrock K. Total hip replacement: between normal rehabilitation and complication. Praxis (Bern 1994), 2014, 103(24): 1439-1446.
14. 周朝波. 人工髖關節置換術治療老年髖關節骨折內固定失敗的臨床研究. 現代中西醫結合雜志, 2015, 24(16): 1753-1755.
15. 傅余良, 趙隆隊, 朱琦, 等. 人工關節置換治療空心釘內固定失敗的股骨頸骨折. 江西醫學, 2013, 48(7): 589-590.

West China Medical Journal

Short-term clinical efficacy of secondary total hip arthroplasty after failure of internal fixation versus primary total hip arthroplasty in elderly patients with displaced femoral neck fracture

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