Clinical Selection Of Bio-type Double-moving Head And Cemented Double-head Replacement For Femoral Neck Fracture In The Elderly

Objective:To explore the clinical choice of biological double head and cement double head replacement for femoral neck fractures in the elderly.Methods:108 patients with artificial double-acting head joint replacement treated by my hospital from December 2015 to December 2017 were selected as the subjects,and the randomized numerical tables were divided into biological double-acting head group(N = 42)and bone cement type double moving head group(N = 66).In the course of the operation,the biological double head was given the biological double head,and the bone cement double head was given the cement double head.The effect of the two groups after the operation was evaluated by 7D,and the patients were followed up for 2 years.Two sets of surgical parameters were recorded,including: operation time,intraoperative bleeding,postoperative drainage,bed time,use of Walker time and post-operative start load time;Harris scale was used to evaluate the body function of two groups before,after 1 month,6 months,12 months and 24 months.The pain of 1D,3D,5D and 7D were evaluated by visual analog pain(VAS)scale.The incidence of postoperative complications was recorded in both groups.Comparison of bone mineral density and cortical thickness between two groups.All data in this study were processed using SPSS17.0 software.RESULTS:(1)There was no statistical significance in the postoperative drainage,the time of using the stepper and the time of starting the load(P & GT;0.05);The surgical time,intraoperative hemorrhage,and bed rest time of the bipedal head group were all short(less)in the bone cement double head group(P & lt;0.05);(2)The score of the Harris scale for 1 month,6 months,12 months and 24 months after the operation of the biological double-acting head group was lower than that before the operation(P & lt;0.05);The score of Harris scale was not statistically significant in 12 months and 24 months after the operation of biological double head group and bone cement double head group(P & GT;0.05);The score of the Harris scale for 1 month and 6 months after the biological double head group was lower than that of the cement double head group(P & lt;0.05);(3)The score of 1D,3D,5D and 7D VAS after surgery in the biological double-acting head group was lower than that before surgery(P & lt;0.05);The score of 1D,3D,5D and 7D VAS after surgery in the biological double-acting head group was lower than that of the cement type double-acting head group(P & lt;0.05);(4)The incidence of dislocation was not statistically significant between the two groups(P & GT;0.05);The incidence of lower extremity deep venous thrombosis and prosthetic loosening sinking in the bipedal head group of biological type was lower than that of the bipedal head group of bone cement(P & lt;0.05);The incidence of periprosthetic fractures and shock symptoms in the biomaterial double head group was lower than that in the bone cement double head group(P & lt;0.05);(5)2 years of follow-up were performed in both groups,and 2 years of excellent rate was not statistically significant in the biological and cement types(P & GT;0.05);(6)Cemented double-acting head replacement is preferred in patients with low bone mineral density.Conclusion:Compared with bone cement type double head replacement,biological type has the advantages of short operation time,simple operation,and less complications in surgery.However,for elderly patients with severe osteoporosis,prosthesis sinking,loosening and other complications are likely to occur after surgery.It is more suitable for bone cement type double moving head joint replacement.Therefore,the clinical treatment should be combined with each patient to choose a suitable double head joint to improve the success rate of surgery.