Retrospective Study Of Cementless Hip Replacement For80Years Or Older Patients With Proximal Femur Fracture

Objective: To evaluate clinical effect and clinical safety of cementlesship replacement for80years or older patients with proximal femur fracture.Methods:36patients who suffered proximal femur fracture andadmitted to our hospital from August2009to March2012were followed.All of them were no less than80years old.5patients were lost to followup.17patients who were treated by hip arthroplasty were defined groupA,14patients treated by internal fixation were group B. Patients of group Aaged from80to94years(84±6.4), contained of6male and11femalepatients; patients of group B aged80to96years (85±5.9), contained of5male and9female cases.Recovery, complications, blood transfusion,VASassessment within perioperative period were recorded, the Harrisassessments were conducted one year after the surgeries,and the one yearmortality were recorded.Results: The mean follow-up time were12.6±1.1months (11～14months). There were a patient of group A died of pulmonary embolism and1patients of group B died within seven months postoperative, statistical difference of mortality was not found betweenthe two groups (P>0.05).9patients of group A had blood transfusion, only2of group B had blood transfusion (P<0.05).5cases of group A (29%)and6cases of group B(43%) occurred postoperative complications suchas heart failure, pneumonia, urinary tract infection, myocardialinfarction, delirium and so on, there was a trend of decline of morbidity ingroup A, but no statistical difference was found(P>0.05).87%patients ofgroup A and69%of group B got excellent Harris score(value≥80) one yearpostoperative(P>0.05). There were one and four patients whose VAS scoreof one year postoperative was no less than4respectively in group Aand group B. One prosthesis dislocation and one prosthesis loosening wereobserved in group A,2patients suffered avascular necrosis of the femoralhead and2cases of nonunion of fracture in group B. Patients who needsecondary operation were1case in group A and3in group B.There wereno sequential fractures, infection, periprosthetic fracture,heterotopicossification, internal fixation failure and malunion observed in otherpatients during the follow-up.Conclusion Patients older than80years with proximal femurfracture undergoing cementless hip replacement could get throughperioperative period safely and get excellent results.