半髋关节置换术的研究进展

Research Progress in Hemiarthroplasty

摘要: 目的：介绍不同髋关节置换术手术入路发展及适应人群，半髋关节置换术改良入路、微创入路及不同假体和有无使用骨水泥的研究进展。方法：广泛查阅国内、外近年相关文献，对半髋关节置换术改良如路、微创入路及假体进行总结分析。结论：半髋关节置换术是治疗老年人股骨颈骨折最主要的手术方式之一。微创及改良入路对比传统入路各有优势，但多是短中期随访结果，需要长期随访数据来证明其优势及并发症发生情况。双极半髋关节置换与单极半髋关节置换的选择尚未达成一致，基于不同情况做出个性化选择。双极半髋关节置换的骨溶解问题，需进行更多改良解决该问题。半髋关节置换使用骨水泥假体有显著优势，但临床实践多使用非骨水泥假体。

Abstract: Objective: To summarize the development of surgical approaches for hemiarthroplasty and their indications, as well as research progress on modified approaches, minimally invasive approaches, different prosthesis designs, and the use of cement. Methods: Based on an extensive review of recent domestic and international literature, the modified approaches, minimally invasive approaches, and prosthesis options for hemiarthroplasty were analyzed. Conclusion: Hemiarthroplasty is one of the primary surgical procedures for managing femoral neck fractures in elderly patients. Minimally invasive and modified approaches offer distinct advantages over the traditional approach; however, the evidence primarily stems from short-to mid-term follow-up studies. Long-term follow-up data is necessary to confirm their benefits and assess complication rates. No consensus exists regarding the choice between bipolar and unipolar hemiarthroplasty, necessitating individualized selection based on specific clinical circumstances. The issue of osteolysis associated with bipolar hemiarthroplasty requires further modifications and investigation. While cemented prostheses demonstrate significant advantages in hemiarthroplasty, uncemented prostheses are more commonly utilized in clinical practice.