Clinical Study of Total Hip Replacement Using Dual Mobility Cup in the Treatment of Femoral Neck Fracture in Patients with Hemiplegia after Stroke

MA Ning; ZHAO Lili; YIN Wei

doi:10.3969/j.issn.1002-3429.2024.13.012

Abstract：Objective To explore the curative effect of total hip replacement using dual mobility cup(DMC)in the treatment of femoral neck fracture in patients with hemiplegia after stroke.Methods The clinical data of 100 patients receiv-ing operation for femoral neck fracture and hemiplegia after stroke from January 2020 to January 2023 were retrospectively ana-lyzed.According to the different surgical methods,they were divided into the research group(total hip replacement using DMC,n=54)and the control group(artificial femoral head replacement,n=46).Perioperative indexes,hip function at 3 and 6 months after operation(Harris score),visual analogue scale(VAS)scores before operation and at 3 and 6 months after operation,inflammatory factors[tumor necrosis factor-α(TNF-α)and interleukin-1(IL-1)]levels before operation and at 3 months after operation were compared between the two groups.The postoperative complications and the excellent and good rate at 1 year after operation were recorded in the two groups.Results The intraoperative blood loss in the research group was greater than that in the control group,and the duration of operation,the time of first off-bed activity and length of hospital stay were longer than those in the control group(P＜0.01).The Harris scores of the research group were higher than those of the control group at 3 and 6 months after operation(P＜0.05).VAS scores at 3 and 6 months after operation were lower in the two groups than those before operation,and lower in the research group than in the control group(P＜0.05).The levels of TNF-α and IL-1 in the two groups at 3 months after operation were lower than those before operation,and the levels in the re-search group were lower than those in the control group(P＜0.05).The total incidence of postoperative complications in the research group was 3.70%(2/54),which was lower than that in the control group[17.39%(8/46)](P＜0.05).There was no significant difference between the two groups with respect to the excellent and good rate(P＞0.05).Conclusion In the treatment of femoral neck fracture in patients with hemiplegia after stroke,total hip replacement using DMC leads to longer duration of operation,more intraoperative blood loss,but fewer postoperative complications,which can better improve the in-flammation,hip function and pain level of patients.