Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August ...Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August 2021 to August 2024 were selected and randomly divided into two groups using a random number table.The experimental group(16 patients)underwent THA surgery,while the control group(16 patients)underwent proximal femoral nail antirotation(PFNA)surgery.Hip joint function and quality of life indicators were compared between the two groups.Results:Before surgery,there was no significant difference in hip joint function and quality of life scores between the two groups(P>0.05).However,at six months postoperatively,the experimental group had higher hip joint function and quality of life scores compared to the control group(P<0.05).The total effective rate was higher in the experimental group than in the control group(P<0.05).The complication rate in the experimental group was similar to that in the control group(P>0.05).Conclusion:THA can improve the clinical efficacy of elderly patients with IFF,minimize postoperative complications,effectively restore hip joint function,and optimize postoperative quality of life.展开更多
AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis wa...AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg.RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise.CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis.展开更多
Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in ad...Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in adults with disabling end-stage hip joint osteoarthritis. Setting: Orthopedic Hospital Setting on the East Coast of the United States. Study Design: Cross-sectional retrospective chart review. Methods: The desired demographic, physical and psychological attributes of 1040 adults with end-stage hip osteoarthritis hospitalized for hip surgery were recorded and subjected to comparison and correlational analyses. These data included gender, self-reported weight, height, numbers and nature of physical and psychological comorbidities, pain intensity, ambulatory capacity and discharge destination. Sub-group analyses of 808 candidates hospitalized for primary unilateral surgery were also conducted using SPSS 16. Results: There were significant (p 【0.05) associations between gender, pain scores, comorbidity numbers and ambulatory capacity. Specifically, women who exhibited higher comorbid disease rates than men, exhibited higher pre-surgery pain levels and greater functional limitations in walking ability before and after surgery than men with the same condition. In sub-group analyses of men and women with the same mean age, comorbid prevalence rates, and body mass indices, women were found to have significantly higher ideal weights on average than men, and those with higher ideal weights recovered more slowly after surgery (p 【0.05). Conclusion: The presentation of hip joint osteoarthritis is not uniform, and may be impacted differentially by gender. Women with high ideal body weights, may be specifically impacted. Whether genetic or other factors account for gender differences in pain and function among adults with disabling hip osteoarthritis observation needs to be examined.展开更多
目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFN...目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFNA选择加长型主钉,短钉组PFNA选择普通型主钉。比较两组围术期指标、骨折愈合时间、完全负重时间、住院时间,复位质量、术后稳定性、手术创伤应激因子[超氧化物歧化酶(SOD)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)]水平、髋关节活动度[髋伸屈活动度(ROM)、髋内-外旋ROM]、髋关节功能及并发症。结果相较于短钉组,长钉组患者手术时间、住院时间较长,失血量、术中X线透视次数较多,完全负重时间、骨折愈合时间较短(P<0.05);两组患者复位质量比较差异无统计学意义(P>0.05);长钉组患者术后稳定性优于短钉组(P<0.05);长钉组患者术后1、3 d SOD低于短钉组,AngⅡ、NE高于短钉组(P<0.05);术后3、6个月两组髋伸屈、髋内-外旋ROM比较差异无统计学意义(P>0.05);长钉组髋关节功能优良率[98.67%(74/75)]较短钉组[89.33%(67/75)]高(P<0.05);长钉组并发症总发生率[1.33%(1/75)]与短钉组[2.67%(2/75)]比较差异无统计学意义(P>0.05)。结论与普通型PFNA主钉相比,采用加长型PFNA主钉治疗31-A3.1~A3.3型IFF患者能促进骨折愈合,提高术后稳定性,改善患者髋关节功能,安全性良好,但创伤较大,围术期恢复较慢。展开更多
目的:比较直接前方入路与后外侧入路全髋关节置换术(THA)治疗股骨颈骨折患者的效果。方法:回顾性分析2022年1月至2025年1月该院收治的82例股骨颈骨折患者的临床资料,根据手术入路不同将其分为观察组和对照组各41例。观察组采用直接前方...目的:比较直接前方入路与后外侧入路全髋关节置换术(THA)治疗股骨颈骨折患者的效果。方法:回顾性分析2022年1月至2025年1月该院收治的82例股骨颈骨折患者的临床资料,根据手术入路不同将其分为观察组和对照组各41例。观察组采用直接前方入路THA治疗,对照组采用后外侧入路THA治疗,比较两组手术相关指标[切口长度、住院时间、术中出血量、术后72 h视觉模拟评分法(VAS)评分、术后引流量]水平,手术前后炎性指标[超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、淀粉样蛋白A(SAA)]水平、术后髋关节功能[Charnley髋关节疗效量表(CHS)、Harris髋关节功能量表(HSS)]评分,以及并发症发生率。结果:两组手术时间比较,差异无统计学意义(P>0.05);研究组切口长度、住院时间均短于对照组,术中出血量、术后引流量均少于对照组,术后72 h VAS评分低于对照组,差异有统计学意义(P<0.05);术后3 d,两组hs-CRP、IL-1β、SAA水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后1个月,观察组CHS、HHS评分均高于对照组,差异有统计学意义(P<0.05);术后3、6个月,两组CHS、HHS评分均高于术后1个月,但组间比较,差异均无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:直接前方入路THA治疗股骨颈骨折患者可缩短切口长度和住院时间,减少术中出血量和术后引流量,降低疼痛评分和炎性指标水平,以及提高髋关节功能评分的效果优于后外侧入路THA治疗。展开更多
文摘Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August 2021 to August 2024 were selected and randomly divided into two groups using a random number table.The experimental group(16 patients)underwent THA surgery,while the control group(16 patients)underwent proximal femoral nail antirotation(PFNA)surgery.Hip joint function and quality of life indicators were compared between the two groups.Results:Before surgery,there was no significant difference in hip joint function and quality of life scores between the two groups(P>0.05).However,at six months postoperatively,the experimental group had higher hip joint function and quality of life scores compared to the control group(P<0.05).The total effective rate was higher in the experimental group than in the control group(P<0.05).The complication rate in the experimental group was similar to that in the control group(P>0.05).Conclusion:THA can improve the clinical efficacy of elderly patients with IFF,minimize postoperative complications,effectively restore hip joint function,and optimize postoperative quality of life.
基金Canadian Institute of Health Science(CIHR)and Zimmer,Warsaw,United States
文摘AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg.RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise.CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis.
文摘Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in adults with disabling end-stage hip joint osteoarthritis. Setting: Orthopedic Hospital Setting on the East Coast of the United States. Study Design: Cross-sectional retrospective chart review. Methods: The desired demographic, physical and psychological attributes of 1040 adults with end-stage hip osteoarthritis hospitalized for hip surgery were recorded and subjected to comparison and correlational analyses. These data included gender, self-reported weight, height, numbers and nature of physical and psychological comorbidities, pain intensity, ambulatory capacity and discharge destination. Sub-group analyses of 808 candidates hospitalized for primary unilateral surgery were also conducted using SPSS 16. Results: There were significant (p 【0.05) associations between gender, pain scores, comorbidity numbers and ambulatory capacity. Specifically, women who exhibited higher comorbid disease rates than men, exhibited higher pre-surgery pain levels and greater functional limitations in walking ability before and after surgery than men with the same condition. In sub-group analyses of men and women with the same mean age, comorbid prevalence rates, and body mass indices, women were found to have significantly higher ideal weights on average than men, and those with higher ideal weights recovered more slowly after surgery (p 【0.05). Conclusion: The presentation of hip joint osteoarthritis is not uniform, and may be impacted differentially by gender. Women with high ideal body weights, may be specifically impacted. Whether genetic or other factors account for gender differences in pain and function among adults with disabling hip osteoarthritis observation needs to be examined.
文摘目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFNA选择加长型主钉,短钉组PFNA选择普通型主钉。比较两组围术期指标、骨折愈合时间、完全负重时间、住院时间,复位质量、术后稳定性、手术创伤应激因子[超氧化物歧化酶(SOD)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)]水平、髋关节活动度[髋伸屈活动度(ROM)、髋内-外旋ROM]、髋关节功能及并发症。结果相较于短钉组,长钉组患者手术时间、住院时间较长,失血量、术中X线透视次数较多,完全负重时间、骨折愈合时间较短(P<0.05);两组患者复位质量比较差异无统计学意义(P>0.05);长钉组患者术后稳定性优于短钉组(P<0.05);长钉组患者术后1、3 d SOD低于短钉组,AngⅡ、NE高于短钉组(P<0.05);术后3、6个月两组髋伸屈、髋内-外旋ROM比较差异无统计学意义(P>0.05);长钉组髋关节功能优良率[98.67%(74/75)]较短钉组[89.33%(67/75)]高(P<0.05);长钉组并发症总发生率[1.33%(1/75)]与短钉组[2.67%(2/75)]比较差异无统计学意义(P>0.05)。结论与普通型PFNA主钉相比,采用加长型PFNA主钉治疗31-A3.1~A3.3型IFF患者能促进骨折愈合,提高术后稳定性,改善患者髋关节功能,安全性良好,但创伤较大,围术期恢复较慢。
文摘目的:比较直接前方入路与后外侧入路全髋关节置换术(THA)治疗股骨颈骨折患者的效果。方法:回顾性分析2022年1月至2025年1月该院收治的82例股骨颈骨折患者的临床资料,根据手术入路不同将其分为观察组和对照组各41例。观察组采用直接前方入路THA治疗,对照组采用后外侧入路THA治疗,比较两组手术相关指标[切口长度、住院时间、术中出血量、术后72 h视觉模拟评分法(VAS)评分、术后引流量]水平,手术前后炎性指标[超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、淀粉样蛋白A(SAA)]水平、术后髋关节功能[Charnley髋关节疗效量表(CHS)、Harris髋关节功能量表(HSS)]评分,以及并发症发生率。结果:两组手术时间比较,差异无统计学意义(P>0.05);研究组切口长度、住院时间均短于对照组,术中出血量、术后引流量均少于对照组,术后72 h VAS评分低于对照组,差异有统计学意义(P<0.05);术后3 d,两组hs-CRP、IL-1β、SAA水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后1个月,观察组CHS、HHS评分均高于对照组,差异有统计学意义(P<0.05);术后3、6个月,两组CHS、HHS评分均高于术后1个月,但组间比较,差异均无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:直接前方入路THA治疗股骨颈骨折患者可缩短切口长度和住院时间,减少术中出血量和术后引流量,降低疼痛评分和炎性指标水平,以及提高髋关节功能评分的效果优于后外侧入路THA治疗。
