골다공증을 동반한 65세이상 고령의 고관절부 골절에서 원추형 대퇴 주대를 이용한 무시멘트형 양극성 인공 고관절 반치환술

Abstract

Purpose: To evaluate the clinical and radiologic results of bipolar hemiarthroplasty using cementless cone stem for osteoporotic hip fracture in patients older than 65 years old age. Materials and Methods: This study examined 110 cases who underwent the bipolar hemiarthroplasty using cementless cone stem via posterolateral approach between September 2006 and December 2011. They were available to follow up of more than 2 years. There were 36 men and 84 women. The mean age of the patients was 78.2 years (range, 65-95), and the mean follow up period was 34 months (range, 24-81). The mean bone mineral density (T-score) was -3.47 (range, -2.54- -6.16). The clinical evaluation was carried out about Harris hip score, ambulatory function, thigh pain. The femoral radiologic evaluation was carried out about position change, osteolysis, subsidence, loosening, intraoperative fracture. The acetabular radiologic evaluation was carried out about acetabular erosion. Results: At last follow up, Harris hip score was 86.2 (range, 64-92) in femoral neck fracture and 81.4 (range, 63-90) in intertrochanteric fracture. 55 cases was recover preoperative ambulatory function. 3 cases appealed mild thigh pain, but all of them recovered through follow up period and had normal radiologic findings. Subsidence occurred in 7 patient, but there were no clinical significant. There were no osteolysis, loosening, intraoperative fracture. There were 2 cases of acetabular erosion due to delayed deep infection. All cases had stable bony fixation. In complication, there were three cases of heterotopic ossification, three cases of deep vein thrombosis, two cases of dislocation and two cases of delayed deep infection. Conclusion: Both clinically and radiologically, bipolar hemiarthroplasty with cementless cone stem is effective and satisfactory method for the treatment of patients older than 65 years old age on osteoporotic hip fracture.