Comparative Study On Curative Effect Between Cemented And Cementless Longer-Stem Hip Arthroplasty For The Traetment Of Unstable Intertrochanteric Fractures In Elderly Patients

Objective: To evaluate the clinical effect of hip arthroplasty for the treatment of unstable intertrochanteric fractures in elderly patients,compare the postoperative curative effect between cemented and cementless longer-stem groupes.Method: Hip arthroplasty were used to treatment of unstable intertrochanteric fractures in 42 cases from Janurary 2003 to Janurary 2008,prothesises were used according to patients, date of admittance,cemented prothesises were used in odd-numbered days, longer-stem cementless prothesises in even-numbered days.A retrospective study was done to analyze clinical effect and X-ray manifestation of 36 cases(36 hips) that were followed up. The time of operation,intra-operative,post-operative blood loss,thingh pain,incidence of early postoperative complications, satisfactory degree of patients,mortality and harris score of hip joint were registered.Comparing 16 cases with cemented and 20 cases with longer-stem cementless hip arthroplasty, Clinical and radiographic evaluations were performed preoperatively;at three,six,twelve months,and yearly thereafter. Register were analyzed by SPSS program.Results: The time of operation,intra-operative,post-operative blood loss,thingh pain,incidence of early postoperative complications had no significant difference between the groups . The harris score of hip joint at final follow-up in two groups were closed to preoperation, the earlier time to leave bed in cemented group.The bone union of intertrochanteric fractures were observed in cementless group. No prothesis shifting,loosening and sinking were found in lately follow-up.Conclusion: The lately term clinical results of cemented group are similar to those of longer-stem cementless group,prothesis are secure,but the long term efficacy is necessary to observation,so a long follow-up is necessary in clinical;Hip arthroplasty and reconstitution proximal femoral are desirable for the management of unstable intertrochanteric fractures in elderly.It benefit the patients earlier rehabilitation and low complications, improve the quality of life;Longer-stem cementless artificial joint arthroplasty were a better choice of osteoporosis intertrochanteric fractures in elderly patients.