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

Video：

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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.	王满宜, 危杰. 股骨颈骨折临床研究的若干问题与新概念. 中华创伤骨科杂志, 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, 陶树清, 曹德宇, 等. 老年移位型股骨颈骨折行髋关节置换术与内固定失效后再行髋关节置换术的疗效对比. 中国医师进修杂志, 2014, 37(11): 17-19.
5.	曾智敏, 何志勇, 陶崑, 等. 股骨颈骨折内固定失败 Ⅱ 期行髋关节置换的早期疗效. 中国骨伤, 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.	薛庆云, 黄公怡, 高新生, 等. 439 例老年人髋部骨折的外伤因素分析. 中华老年医学杂志, 1996, 15(4): 276-278.
11.	张化武, 王栋, 赵磊. 三种术式治疗老年人股骨颈骨折疗效对比观察. 山东医药, 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. 人工髋关节置换术治疗老年髋关节骨折内固定失败的临床研究. 现代中西医结合杂志, 2015, 24(16): 1753-1755.
15.	傅余良, 赵隆队, 朱琦, 等. 人工关节置换治疗空心钉内固定失败的股骨颈骨折. 江西医学, 2013, 48(7): 589-590.

1. 王满宜, 危杰. 股骨颈骨折临床研究的若干问题与新概念. 中华创伤骨科杂志, 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, 陶树清, 曹德宇, 等. 老年移位型股骨颈骨折行髋关节置换术与内固定失效后再行髋关节置换术的疗效对比. 中国医师进修杂志, 2014, 37(11): 17-19.
5. 曾智敏, 何志勇, 陶崑, 等. 股骨颈骨折内固定失败 Ⅱ 期行髋关节置换的早期疗效. 中国骨伤, 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. 薛庆云, 黄公怡, 高新生, 等. 439 例老年人髋部骨折的外伤因素分析. 中华老年医学杂志, 1996, 15(4): 276-278.
11. 张化武, 王栋, 赵磊. 三种术式治疗老年人股骨颈骨折疗效对比观察. 山东医药, 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. 人工髋关节置换术治疗老年髋关节骨折内固定失败的临床研究. 现代中西医结合杂志, 2015, 24(16): 1753-1755.
15. 傅余良, 赵隆队, 朱琦, 等. 人工关节置换治疗空心钉内固定失败的股骨颈骨折. 江西医学, 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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