关键词: 双极半髋关节置换术, 全髋关节置换术, 股骨颈骨折, 炎症因子, 髋关节活动度, 生活质量

Abstract: Objective To compare and analyze the effects of bipolar hemihip replacement（BHA）and total hip replacement（THR）in the treatment of femoral neck fracture（FNF）．Methods The clinical data of 90 patients with FNF in the Luoyang Hospital,Dongzhimen Hospital,Beijing University of Chinese Medicine,from June 2019 to April 2023 were retrospectively collected．The patients were divided into two groups according to the difference in surgical treatment plan．The BHA group（45 cases）received BHA treatment,and the THR group（45 cases）received THR treatment．The perioperative indicators,preoperative and postoperative inflammatory factor levels,postoperative hip joint mobility at six months,preoperative and postoperative quality of life [European Quality of Life Scale（EQ-5D score）]were compared between the two groups．Results The operation time（108.76±15.33）min,ambulation time（40.37±10.24）h,and hospitalization time（19.02±5.11）d in the THR group were longer than those in the BHA group [（53.49±10.12）min,（25.92±7.15）h,（15.16±4.87）d]（t=20.184,8.630,3.668,respectively,all P<0.05）．The intraoperative blood loss（318.69±35.14）mL and postoperative drainage volume（129.74±21.03）mL were both higher than those in the BHA group [（224.07±29.35）mL,（90.35±17.48）mL]（t=13.863,9.663,respectively,all P<0.001）．There was no significant difference in the incidence of complications between the groups（P>0.05）．Three days after surgery,the serum levels of interleukin-1,interleukin-6,and C-reactive protein in the BHA group were（17.35±3.06）pg/L,（24.82±4.31）pg/L,and（26.17±4.59）pg/L,respectively,which were lower than those in the THR group（20.16±3.48）pg/L,（27.04±5.06）pg/L,and（28.90±5.12）pg/L（t=4.068,2.241,2.663,respectively,all P<0.05）．There was no significant difference in the range of motion of internal rotation,flexion,external rotation,abduction,and adduction of the hip joint and EQ-5D scores between the two groups at six months after surgery（all P>0.05）． Conclusions Compared with THR,BHA can reduce perioperative blood loss in FNF patients,reduce postoperative inflammatory factor expression level,shorten operation and ambulation time,and promote recovery．

Key words: bipolar hemiarthroplasty, total hip replacement, femoral neck fracture, inflammatory factors, range of motion of the hip joint, quality of life