Comparison of two methods for reducing length discrepancy in hip hemiarthroplasty / 中华老年医学杂志

Objective:To compare the accuracy of two methods in reducing leg length discrepancy(LLD)during hip hemiarthroplasty.Methods:We retrospectively analyzed 89 patients of hip hemiarthroplasty who suffered from femoral neck fracture.There were 47 patients in the new method group(NM), and 42 patients in the traditional method group(traditional method, TM)which comparing the position of the greater trochanter tip and the center of the femoral head.In the NM group, the distance from the center of femoral head to the lesser trochanter(L)and the diameter of femoral head(D)of the healthy side hip were measured on preoperative anteroposterior pelvic X-ray film, and the ratio(R)of D to L was calculated.During operation, the diameter of the femoral head(d)was measured with a caliper, and the distance should be obtained from the center of the femoral head prosthesis to the lesser trochanter according to the ratio R of the healthy side.The difference of postoperative LLD between the two groups and the incidences of |LLD| in each range were compared.Results:In the NM group, the maximum LLD was 11.10 mm and the minimum LLD was -4.0 mm, with an average of(4.4±3.2)mm, 80.9%(38/47)| LLD | < 6 mm, 93.6%(44/47)| LLD | < 10 mm, 6.4%(3/47)| LLD | ≥ 10 mm.In the TM group, the maximum LLD was 13.2 mm and the minimum LLD was -8.3 mm, with an average of (6.2±5.1)mm, 42.9%(18/42)|LLD|<6 mm, 69.0%(29/42)|LLD| <10 mm, 31.0%(13/42)|LLD|≥10mm.The differences of patients of the mean postoperative LLD and the incidences of |LLD| in each range between two the groups were statistically significant( t=-2.036、 χ2=14.629, P=0.046、0.001). Conclusions:The new method is simple, convenient, more accurate and can obtain a more satisfactory LLD compared with the traditional method which refers to the relative position of the great trochanter tip and the center of the femoral head.

Bipolar hemiarthroplasty for hemiplegic side femoral neck fractures in elderly patients / 中华老年医学杂志

Objective The feasibility and the curative effect of bipolar hemiarthroplasty for hemiplegic side femoral neck fractures in elderly patients were evaluated.Methods The patients suffering from hemiplegic side femoral neck fractures and undergoing bipolar hemiarthroplasty in Beijing Tongren Hospital were followed-up during 2012-2015.The postoperative Harris Score and the complications such as infection,deep vein thrombosis and dislocation were collected.Results Totally 25 patients(25 hips)were followed-up.The average age was 70.1 years,and mean follow-up period was 24.3 months (10-42 months).The mean Barthel index score was higher (77.4 ± 14.7,ranging from 40-95 points) after operation than before operation[25.00 ± 5.95 (15-35 points)] with a statistically significant difference(t=-21.374,P＜＜0.05).The postoperative Harris Score was 83.5± 8.9(60-95 points).According to Harris score,the excellent and good rate was 80.0％.The patient's satisfaction rate was 88.0％.Conclusions Choosing proper prosthesis and fixing measure,and keeping the function and tension of short extorsion muscles can achieve the satisfactory results for hemiplegic side femoral neck fractures in elderly patients.

Medium-term follow-up after mobile-bearing total knee arthroplasty / 中国组织工程研究

BACKGROUND:Mobile-bearing prosthesis has advantages in theoretic design, in vitro kinematics and abrasion, but it remains unclear whether its clinical outcomes are better than fixed-bearing prosthesis at present. OBJECTIVE:To evaluate the medium-term results of total knee arthroplasty using mobile-bearing prosthesis to provide clinical evidence for the choice of prosthesis. METHODS:The patients who suffered from osteoarthritis or rheumatoid arthritis and underwent total knee arthroplasty with PFC Sigma RP in Beijing Tongren Hospital from December 2006 to June 2009 were included in this study. The postoperative Knee Society Score, Knee Society Score Function Score, Patel ar Score and the Pain Score, range of motion, maximun flexion and extension angle were col ected and compared with pre-operation. The complications, such as infection, patel a clicking, polyethylene insert dislocation, and deep vein thrombosis were recorded after replacement. The anterior-posterior, lateral and Merchant position X-ray images were taken to evaluate the tibiofemoral alignment, radiolucent lines, and patel ar dislocation. Then, the results of other medium-term fol ow-up researches were compared with fixed-bearing arthroplasty. RESULTS AND CONCLUSION:Final y, 31 patients (45 knees) were fol owed up. The average age was 64.56±10.33 years, and fol ow-up period was 3.9-7.6 years. The postoperative scores, range of motion, maximun flexion and extension angle were improved obviously, but there were no differences with other medium-term fol ow-up researches. No radiolucent lines, prosthetic loosening or polyethylene insert dislocation was found. Lateral patel ar release was done, but no patel ar dislocation or subluxation appeared in al patients. Two patients (2 knees) accompanied patel a clicking. Results indicated that the medium-term clinical result was satisfactory. No patel ar dislocation or subluxation was found, although only lateral patel ar release was done. This may be the superiority of mobile-bearing arthroplasty.