بررسی‌ نتایج‌ آرتروپلاستی‌ بای پولار مفصل‌ هیپ‌ در میان مدت

نوع مقاله : مقاله پژوهشی

نویسندگان

گروه ارتوپدی، دانشکده پزشکی‌، دانشگاه علوم پزشکی‌ مازندران، ساری، ایران

چکیده
چکیده:
مقدمه: آرتروپلاستی‌ به‌ عنوان یک‌ گزینه‌ درمانی‌، به‌طور گسترده‌ای در بیماران مسن‌ مبتلا به‌ شکستگی‌ گردن استخوان فمور مورد حمایت‌ قرار گرفته‌ است‌ هر چند نوع آرتروپلاستی‌ هنوز مورد‌‌ بحث‌ است‌.
مواد و روش‌ها: این‌ مطالعه‌ به‌ منظور ارزیابی‌ نتیجه‌ عملکردی همی‌ آرتروپلاستی‌ دوقطبی‌ (BHA) انجام شد. ٤٩ بیمار با شکستگی‌ داخل‌ کپسولی‌ گردن فمور که‌ با BHA جراحی‌ شده بودند وارد مطالعه‌ شدند. پیگیری بالینی‌ و رادیولوژیک‌ انجام شد. نتایج‌ عملکردی با استفاده از نمره هریس‌ هیپ‌ اصلاح شده ارزیابی‌ شد.
نتایج و بحث: در مطالعه‌ حاضر ٩ بیمار (٤/١٨ %) زیر ٦٠ و ٤٠ بیمار (٦/٨١ %) سن‌ بالای ۶۰ سال داشتند. در گروه ٦٠< سال، ٧/٦٦ % مرد و ٣/٣٣ % زن و در گروه ٦٠ ≥ سال، ٤٥% مرد و ٥٥% زن بودند. میانگین‌ دوره پیگیری در افراد ٦٠< سال٦٦/٤٨ ماه و در افراد ٦٠ ≥ سال ٦٠/٤٦ ماه بود. اختلاف میانگین‌ نمره هیپ‌ هریس‌ بین‌ دو گروه به‌طور حاشیه‌ای معنی‌دار بود (٠٦/٠=p). در طبقه‌بندی عملکرد بر اساس نمره هریس‌ هیپ‌ در افراد ٦٠< سال ٦/٥٥ % عملکرد ضعیف‌، ٣/٣٣ % نسبتاً خوب و ١/١١ % خوب را نشان دادند. این‌ نسبت‌ها در افراد ٦٠≥ سال به‌ ترتیب‌ ٨٥ %، ٥/٧ % و ٥/٧% بود.
نتیجه‌گیری: مطالعه‌ حاضر نتوانست‌ یک‌ پیامد عملکردی رضایت‌بخش‌ را پس‌ از BHA در درازمدت مشاهده کند؛ بنابراین‌ ارزیابی‌ عملکرد هیپ‌ و دلایل آن‌ها در بیماران تحت‌ BHA در درازمدت نکته‌ ایست‌ که‌ نیاز به‌ بررسی‌ دارد. فرسایش‌ استابولوم متعاقب‌ BHA شاید دلیل‌ احتمالی‌ عملکرد نسبتاً ضعیف‌ در این‌ بیماران در درازمدت باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله English

Outcome of Bipolar Hip Arthroplasty in Femoral-Neck Fracture (Medium-Term Result)

نویسندگان English

Masoud Shayesteh Azar
mostafa kalteh
Masoud Gharib
Jamshid Yazdani Cherati
Orthopedic Research Center, Faculty of Medicine, Mazandaran University of Medical science, Sari, Iran.
چکیده English

Abstract
Introduction: Arthroplasty as a treatment option for femoral neck fracture in elderly people has been widely supported although the type of arthroplasty is debatable. This study was conducted to evaluate the functional outcome of bipolar hemiarthroplasty (BHA).
Materials & Methods: 49 patients with femoral neck fracture who were operated with BHA within 5 years were included in the study. The clinical, radiographic, and functional results, using modified Harris-Hip score (HHS), were evaluated with a follow-up of 47 months.
Results & Discussion: 49 patients, - 66.7% men and 33.3% women, with 9 patients (18.4%) below 60 and 40 (81.6%) over 60 years old were studied. The average follow-up period was 48.66 months in people below 60 years and 46.60 months in over 60 years patients. The difference in the average HHS between the two groups was marginally significant (p=0.06). In the performance section of HHS, 55.6% showed poor performance, 33.3% relatively good performance and 11.1% good performance in people below 60- years group. These scores for over 60- years group were 85%, 7.5% and 7.5% in respectively.
Conclusion: The present study could not observe a satisfactory functional outcome after BHA in below or over 60-years population in this medium-term study. Therefore, evaluating the hip function after BHA in the long term and the cause for poor function is needed to be investigated. Slow erosion of the acetabulum following BHA can be a possible reason, lowering performance which requires in-depth investigation in long term studies.
Keywords: Femoral neck fractures, Hemiarthroplasty, Outcome assessment.

کلیدواژه‌ها English

Femoral neck fractures
Hemiarthroplasty
Outcome assessment
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