Journal of Orthopaedics, Trauma and Rehabilitation

Background

In 2013, Hospital Authority of Hong Kong replaced Austin Moore Arthroplasty (AMA) with cemented Exeter hemiarthroplasty for displaced femoral neck fractures. This study evaluated whether this new guidelines resulted in better mortality, hospital service reattendances and rehabilitation outcomes.

Objectives

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Methods

Patients aged 65e84 years with hemiarthroplasty done in a tertiary hospital during 2012e 2014 were reviewed retrospectively. AMA group included AMAs carried out during years 2012e2013, and Exeter group included cemented modular Exeter hemiarthroplasties carried out during years 2013e2014. All patients were followed-up for 2 years.

Results

The Exeter group performed significantly better in rehabilitation outcomes than AMA group in terms of mobility score, independent and outdoor walking and community dwelling. They also had less hospital service reattendances due to falls, refractures and implant-related causes. There was a trend towards lower mortality in the Exeter group with increasing duration from operation.

Conclusion

The new guidelines in replacing AMA with cemented Exeter hemiarthroplasty resulted in better patient outcomes.

中 文 摘 要

背景: 香港醫院管理局於2013年以Exeter骨水泥半髖關節置換術代替Austin-Moore非骨水泥半髖關節置換 術(AMA)作爲移位髖頸骨折之首選儀器。此論文檢討這個新指引會否改善病者的死亡率、再度使用醫院服 務、和復康成果。 方法: 我們回顧性研究於2012-2014年間在一間三級醫院内因髖頸骨折進行半髖關節置換術, 年齢介乎65-84 歳的病者。AMA組包括了於2012-2013年間進行的Austin-Moore非骨水泥半髖關節置換術, 而Exeter組則包 括於2013-2014年間進行的Exeter骨水泥半髖關節置換術。所有病者均追蹤至術後兩年。 結果: Exeter組較AMA 組在復康成果中有顯著的優勢, 尤其是行動指數、獨立行動及戶外行動能力、及社區 居住能力。Exeter組亦顯著較少因爲跌倒、再骨折及儀器有關之原因再度使用醫院服務。隨著手術後的時間 越長, Exeter組亦有趨勢有較低的死亡率。 結論: 香港醫院管理局年以Exeter骨水泥半髖關節置換術代替Austin-Moore非骨水泥半髖關節置換術的新指 引改善了病者的結果。