Artificial Hip Replacement For Femoral Neck Fracture In Elderlyosteoporotic Retrospective Analysis

ObjectiveTo explore the application of biological and bone cement hip arthroplasty in the treatment of elderly osteoporotic femoral neck fracture, in order to provide reference for the elderly osteoporotic femoral neck fracture patients with the joint prosthesis.MethodsThis study is a retrospective analysis, from May 2012 to May 2015 in our hospital during artificial hip replacement in elderly with osteoporotic osteoporotic GardenⅢ and GardenⅣ type of femoral neck fracture were followed up. A total of 146 cases were selected, male 50 patients,96 cases of female patients, aged 65-98 years, average 77.7 years old.Biological type artificial hip replacement group including biological type total hip 75 cases, biological type artificial femoral head 44 cases.27 cases of bone cement type artificial femoral head. The bone of the femoral neck was classified according to the Singh index to determine the osteoporosis, measure the tuberosity below the lateral femoral cortical bone thickness 2 cm, preoperative determination of life self-care ability. Through the review of the case, to review the hospital, telephone follow-up, etc., from the operative time, intraoperative blood loss, postoperative complications, the average length of hospital stay, postoperative down time, Harris hip score and good rate and other clinical indicators of research and analysis.Results1. Biological type artificial hip replacement group and bone cement type artificial hip replacement group were no significant differences in age, sex, Garden typing, bone quality, lateral femoral cortical bone thickness,was not statistically significant (P> 0.05).2. At 3 months,6 months and 12 months after operation, there was no difference in the Harris score between biological type artificial hip replacement group and bone cement type artificial hip replacement group. There was was not statistically significant (P>0.05).3. Biological type artificial hip replacement group and bone cement type artificial hip replacement group had significant differences in postoperative complications, the average operation time, intraoperative blood loss, with statistical significance (P <0.05); The two groups in the average length of hospital stay, postoperative down time there was no significant difference on fields, no statistical significance (P> 0.05).Conclusions1. Biological artificial hip replacement is a feasible option for the treatment of osteoporotic femoral neck fracture in the elderly. Bone quality is Singh 3 level and above, the lateral femoral cortical bone thickness (8 mm) or higher, patient who former life self-care ability of optimal, choose biological type total hip replacement; Bone quality than Singh index level 3, excellent lateral femoral cortical bone thickness (> 6mm), intermediate above injury before life self-care ability evaluation, even over the age of 80, choose biological type artificial femoral head replacement.2. Bone cement prosthesis can provide immediate stability of early, bone quality for Singh index grade 1-2 levels of patients or bone quality is Singh index level 3, lateral femoral cortical bone thickness less than excellent (< 6mm), evaluation of pre-injury daily living less than an excellent choice in patients with bone cement type artificial femoral head replacement.3. Biological and bone cement type artificial hip joint replacement is an effective method for the treatment of osteoporotic femoral neck fracture in the elderly, It is superior to bone cement in safety.