老年股骨颈骨折患者全髋关节置换术后发生假体脱位的影响因素

Influencing factors of prosthesis dislocation after hip arthroplasty in elderly patients with femoral neck fractures

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摘要目的:分析老年股骨颈骨折患者全髋关节置换术后发生假体脱位的影响因素。方法:回顾性分析2018年10月至2021年10月于该院行全髋关节置换术治疗的188例老年股骨颈骨折患者的临床资料。术后随访1年,记录患者假体脱位发生情况,对股骨颈骨折患者全髋关节置换术后发生假体脱位的相关因素进行单因素和多因素分析。结果:两组性别,手术时间,合并高血压、糖尿病、高脂血症情况比较,差异均无统计学意义(P>0.05);脱位组年龄、BMI、骨密度、手术入路、股骨头假体直径、股骨柄前倾角度与未脱位组比较,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,年龄≥75岁、BMI≥24 kg/m^(2)、骨密度降低、后外侧入路、股骨头假体直径<30 mm、股骨柄前倾角度>15°是老年股骨颈骨折患者全髋关节置换术后发生假体脱位的独立危险因素(OR>1,P<0.05)。结论:年龄≥75岁、BMI≥24 kg/m^(2)、骨密度降低、后外侧入路、股骨头假体直径<30 mm、股骨柄前倾角度>15°是老年股骨颈骨折患者全髋关节置换术后发生假体脱位的独立危险因素,临床可据此采取针对性的预防措施。 Objective:To analyze influencing factors of prosthesis dislocation after hip replacement in elderly patients with femoral neck fractures.Methods:The clinical data of 188 elderly patients with femoral neck fracture who underwent total hip replacement in this hospital from October 2018 to October 2021 were retrospectively analyzed.These patients were followed up for 1 year.The incidence of prosthesis dislocation was recorded.The related factors of prosthesis dislocation after hip arthroplasty in these patients with femoral neck fractures were analyzed by univariate and multivariate analysis.Results:There were no significant differences in gender,operation time,hypertension,diabetes and hyperlipidemia between the two groups(P>0.05).There were significant differences in age,BMI,bone mineral density,surgical approach,femoral head prosthesis diameter and femoral stem anteversion angle between the dislocation group and the non-dislocation group(P<0.05).Logistic regression analysis showed that age≥75 years,BMI≥24 kg/m^(2),decreased bone mineral density,posterolateral approach,femoral head prosthesis diameter<30 mm,femoral stem anteversion angle>15°were independent risk factors for prosthesis dislocation after hip arthroplasty in the elderly patients with femoral neck fractures(OR>1,P<0.05).Conclusions:Age≥75 years,BMI≥24 kg/m^(2),decreased bone mineral density,posterolateral approach,femoral head prosthesis diameter<30 mm,femoral stem anteversion angle>15°are the independent risk factors for prosthesis dislocation after hip arthroplasty in the elderly patients with femoral neck fractures.Targeted preventive measures can be taken accordingly.

作者卢训兵 LU Xunbing(Department of Orthopaedics of Ningling County People’s Hospital,Shangqiu 476700 Henan,China)

机构地区宁陵县人民医院骨科

出处《中国民康医学》 2023年第4期11-14,共4页 Medical Journal of Chinese People’s Health

关键词股骨颈骨折老年全髋关节置换术假体脱位体质量指数骨密度影响因素 Femoral neck fracture Elderly Hip arthroplasty Prosthesis dislocation Body mass index Bone density Influencing factor

分类号 R683.42 [医药卫生—骨科学]