The Efficacy Of Uncemented Hemiarthroplasty In Aged Patients With Femoral Neck Fracture

ObjectiveTo retrospectively analyze the function and the safety of uncemented hip hemiarthroplasty in the treatment of femoral neck fractures in elderly and aged patients,and to determine the efficacy of uncemented hemiarthroplasty in elderly and aged patients,especially the efficacy in aged patients.Patients and MethodsFrom January 2015 to June 2018,45 aged patients whose age were 80 or over 80 were admitted in the Department of Orthopaedics,Second Hospital of Tianjin Medical University for the treatment of femoral neck fractures,treating with uncemented hip hemiarthroplasty.A total of 60 elderly patients whose age were 65 to 79 years were selected as control.Baseline data,including age,gender,fracture side and Garden classification,Charlson comorbidity index score,ASA score,and laboratory report,as well as preoperative waiting time,duration of surgery,length in the hospital,and intraoperative bleeding,were collected and recorded for both groups and calculated perioperative hidden blood loss.All patients were followed up for 6 to 48 months except for the patient died in the hospital.The complications and hip function during the follow-up period were recorded.The data we collected were compared between two groups,and P <0.05 considered statistically significant.ResultsThe average age of aged patients was 84.7±4.0 years old,and the average age of elderly patients was 73.1±4.1 years old.There was no difference between the two groups in fracture side and Garden classification.The preoperative Charlson comorbidity index score and ASA score of the aged patients were both higher than that of the elderly patients,while the preoperative hemoglobin and albumin levels of the aged patients were lower than that of the elderly patients,suggesting that the aged group had more preoperative comorbidities and a higher risk of surgery and death.There were no statistical differences in preoperative waiting time,operation time,hospital stay,and intraoperative blood loss between the two groups.The incidence of complications was 15.6% in the aged group and 15.0% in the elderly group,and there was no statistical difference in the incidence of complications between the two groups.One aged patient died in the hospital due to heart failure postoperatively and there were no other deaths within 30 days.Irrespectively,elderly patients have less hidden blood loss during surgery,and hip function is superior to aged patients.ConclusionUncemented hip hemiarthroplasty has a good early effect in the treatment of femoral neck fractures in both elderly patients and aged patients.However,aged patients have higher risk of surgery and death due to age and other related factors,and more hidden blood loss perioperatively.They may face more severe blood insufficient that require the more attention of orthopedic surgeons.