Comparison of clinical results of flattapered and rectangular stems in partial hip replacement based on proximal femur fracture

Yıl 2024, , 170 - 177, 29.05.2024

Mehmet Fevzi Çakmak , Levent Horoz

https://doi.org/10.21673/anadoluklin.1357702

Öz

Aim: Hemiarthroplasty is commonly used in proximal femur fractures to provide early mobilization and weight bearing to the patient. Cemented and cementless femoral stems are commonly used in this procedure. Cementless prostheses have many advantages and disadvantages, and their relevance to stem design is controversial. This study aimed to compare flat-tapered and rectangular femoral stems in hemiarthroplasty.

Methods: The study population consisted of a third-level hospital’s archive orthopedics and traumatology clinic. Our study was retrospective. A total of 176 patients who underwent cementless hemiarthroplasty in proximal femoral fractures between January 2017 and January 2022 were included in the study. Within these protocols, 64 patients underwent hemiarthroplasty using a flat-tapered stem (Group 1), and 58 patients underwent hemiarthroplasty using a rectangular stem (Group 2). At the last follow-up of the patients, the Harris hip score, Visual Analogue Scale, and early and long-term complications were evaluated.

Results: No significant differences among the patients were observed regarding Harris hip scores and Visual Analogue Scale values. The study groups were analyzed in terms of developing complications. Similar results were found in both groups regarding periprosthetic femur fractures.

Conclusion: Our study found no significant difference between flat-tapered and rectangular stems in terms of clinical outcomes and periprosthetic femur fracture in cases of cementless hemiarthroplasty. As a result, rectangular stems can be safely preferred in hemiarthroplasty.

Anahtar Kelimeler

Femoral neck fractures, hemiarthroplasty, hip prosthesis, periprosthetic fractures

Proksimal femur kırığında düz-konik ve kare kesit stemler ile yapılan parsiyel kalça protezlerinin klinik sonuçlarının karşılaştırılması

Öz

Amaç: Hemiartroplasti, proksimal femur kırıklarında da hastaya erken mobilizasyon ve yük verme olanağı sağlamak amacıyla sık kullanılan bir yöntemdir. Bu prosedürde yaygın olarak çimentolu ve çimentosuz femoral gövdeler kullanılır. Çimentosuz protezlerin birçok avantajı ve dezavantajı vardır ve gövde tasarımıyla ilişkisi tartışmalıdır. Bu çalışmanın amacı hemiartroplastide konik ve kare kesit femur gövdelerini karşılaştırmaktır.

Yöntemler: Araştırma, üçüncü basamak bir hastanenin ortopedi ve travmatoloji kliniğinin arşivinden oluşturulan, retrospektif bir çalışmadır. Proksimal femur kırığı tanısıyla 2017- 2022 yıllarında çimentosuz hemiartroplasti uygulanan 64 konik (Grup 1) ve 58 kare kesit stem (Grup 2) olmak üzere toplam 176 hastaya hemiartroplasti uygulanan hasta çalışmaya dahil edildi. Hastaların son kontrollerinde Harris kalça skoru, Visual Analogue Scale ve erken ve geç dönem komplikasyonları değerlendirildi.

Bulgular: Gruplar arasında Harris kalça skoru ve Visual Analogue Scale değerleri açısından anlamlı fark gözlenmedi. Periprostetik kırıklar açısından karşılaştırıldığında her iki grupta da benzer sonuçlar elde edildi.

Sonuç: Çalışmamızda çimentosuz hemiartroplasti olgularında konik gövde ve kare kesit gövde arasında klinik sonuçlar ve periprostetik femur kırığı açısından anlamlı bir fark bulunmamıştır. Bu nedenle proksimal femur kırığı zemininde kare kesit femoral stem ile yapılan hemiartroplasti prosedürü güvenli bir yöntem olarak kabul edilmektedir.

Anahtar Kelimeler

Hemiartroplasti, femoral boyun kırıkları, kalça protezleri, protez çevresi kırıklar

Kaynakça

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