Journals / Türk Osteoporoz Dergisi / 2021 / Cilt: 27 - Sayı: 1

Long-stem Prosthesis for Intertrochanteric and Femoral Neck Fractures in the Elderly: Retrospective Comparison of Short-term Clinical Outcomes

Yaşlılarda İntertrokanterik ve Femur Boyun Kırıklarında Uzun Stemli Protezler: Kısa Dönem Klinik Sonuçlarının Retrospektif Karşılaştırılması

Pages
30–36
Publication Date
2022-11-06
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

A longer follow-up to evaluate the efficacy of these prostheses is warranted.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: Hip fracture treatment in elderly patients remains challenging.
📊
Key Findings & Data:This study aimed to evaluate short-term clinical results of long-stem cementless arthroplasty in elderly patients with femoral neck and intertrochanteric fractures.Materials and Methods: We collected data of patients we treated with long-stem cementless arthroplasty between January 2011 and December 2019 due to hip fractures.
💡
Conclusion & Impact:A longer follow-up to evaluate the efficacy of these prostheses is warranted.
🔬Design:Research Article
📍Scope:2011 Verileri
⚙️Variables:Domain Parameters

Abstract

Objective: Hip fracture treatment in elderly patients remains challenging. This study aimed to evaluate short-term clinical results of long-stem cementless arthroplasty in elderly patients with femoral neck and intertrochanteric fractures.Materials and Methods: We collected data of patients we treated with long-stem cementless arthroplasty between January 2011 and December 2019 due to hip fractures. This study included 48 patients (≥65 years of age) with femoral neck and intertrochanteric fractures. The patients underwent either bipolar or total hip arthroplasty. A 2-year follow-up was conducted in all the patients. Outcomes were evaluated with the Harris hip score (HHS), Koval categories, complications and hip and mid-thigh pain. We compared clinical results of patients with femoral neck fractures and those with intertrochanteric fractures.Results: The mean follow-up period was 57 (34-92) months. Sixteen patients had femoral neck fractures and 32 had intertrochanteric fractures. No difference in demographic characteristics and comorbidities was noted between groups. The mean preoperative Barthel index of activities of daily living score was 79. At the last follow-up, the mean HHS of the control group was 77 and the mean Koval categories score was 3. Revision surgeries were conducted in two patients due to dislocation. Infection was observed in one patient and was treated by debridement and anti-biotherapy. Implant loosening and periprosthetic fractures were not noted.Conclusion: With fair outcomes, long-stem cementless arthroplasty is a potential treatment for hip fractures in elderly patients. A longer follow-up to evaluate the efficacy of these prostheses is warranted.

Özet

Amaç: Yaşlılarda kalça kırıklarının tedavisi hala güçlükler içermektedir. Çalışmamızda; femur boyun ya da intertrokanterik kırığı olan yaşlı hastalarda uzun stemli çimentosuz artroplastinin kısa dönem klinik sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: Ocak 2011’den Aralık 2019’a kadar kalça kırığı nedeniyle uzun stemli çimentosuz artroplasti ile tedavi ettiğimiz hastaların verilerini topladık. Femur boyun ya da intertrokanterik kırığı olan 48 hasta (≥65 yaş) çalışmaya dahil edildi. Hastalara bipolar veya total kalça artroplastisi uygulandı. Tüm hastalar en az 2 yıl takip edildi. Sonuçlar Harris kalça skoru (HHS), Koval kategorileri, komplikasyon, kalça ağrısı ve uyluk önü ağrısı açısından değerlendirildi. Femur boyun kırığı olan hastalarla ve intertrokanterik kırığı olan hastaların klinik sonuçlarını karşılaştırdık. Bulgular: Ortalama takip süresi 57 (34-92) aydı. On altı hastada femur boyun kırığı, 32 hastada intertrokanterik kırık vardı. Demografik özellikler ve komorbiditeler açısından gruplar arasında fark yoktu. Preoperatif, Barthel günlük yaşam aktivite indeksi puanı ortalama 79 olarak hesaplandı. Son kontrollerde ortalama HHS 77 ve Koval kategorileri 3’tü. Çıkık sebebiyle 2 hastaya revizyon uygulandı. Sadece 1 hastada enfeksiyon vardı ve debridman ve antibiyoterapi ile tedavi edilebildi. İmplant yetersizliği veya periprostetik kırık hiçbir hastada görülmedi. Sonuç: İyi klinik sonuçlarla, uzun stemli çimentosuz artroplasti yaşlı hastalarda kalça kırıklarının tedavisi için bir seçenek olabilir. Bu protezlerin etkinliğini değerlendirmek için daha uzun takip süreleriyle yapılmış çalışmalar daha uygun olacaktır.

🔖

Cite This Article

ÇEKOK, K., TÜRKEN, M. A., AKDEMİR, M., BİÇEN, Ç. (2022). Long-stem Prosthesis for Intertrochanteric and Femoral Neck Fractures in the Elderly: Retrospective Comparison of Short-term Clinical Outcomes. Türk Osteoporoz Dergisi, Cilt: 27 - Sayı: 1, 30–36. https://ajindex.com/articles/639594

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (12)

  1. Chang JD, Kim IS, Lee SS, Yoo JH, Hwang JH. Unstable intertrochanteric versus displaced femoral neck fractures treated with cementless bipolar hemiarthroplasty in elderly patients; a comparison of 80 matched patients. Orthop Traumatol Surg Res 2016;102:695-9
  2. Alexiou KI, Roushias A, Varitimidis SE, Malizos KN. Quality of life and psychological consequences in elderly patients after a hip fracture: a review. Clin Interv Aging 2018;13:143-50
  3. Veldman HD, Heyligers IC, Grimm B, Boymans TA. Cemented versus cementless hemiarthroplasty for a displaced fracture of the femoral neck: a systematic review and meta-analysis of current generation hip stems. Bone Joint J 2017;99:421-31
  4. Lee YK, Won H, Roa KRU, Ha YC, Koo KH. Bipolar hemiarthroplasty using microarc oxidation-coated cementless stem in patients with unstable intertrochanteric fracture. J Orthop Surg (Hong Kong) 2019;27:2309499019847815
  5. Brox WT, Roberts KC, Taksali S, Wright DG, Wixted JJ, Tubb CC, et al. The American Academy of Orthopaedic Surgeons Evidence- Based Guideline on Management of Hip Fractures in the Elderly. J Bone Joint Surg Am 2015;97:1196-9
  6. Nie B, Wu D, Yang Z, Liu Q. Comparison of intramedullary fixation and arthroplasty for the treatment of intertrochanteric hip fractures in the elderly: A meta-analysis. Medicine (Baltimore) 2017;96:7446
  7. Zhou S, Liu J, Zhen P, Shen W, Chang Y, Zhang H, et al. Proximal femoral nail anti-rotation versus cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture in the elderly: a retrospective study. BMC Musculoskelet Disord 2019;20:500
  8. Kim SH, Meehan JP, Lee MA. Surgical treatment of trochanteric and cervical hip fractures in the United States: 2000-2009. J Arthroplasty 2013;28:1386-90
  9. Ma KL, Wang X, Luan FJ, Xu HT, Fang Y, Min J, et al. Proximal femoral nails antirotation, Gamma nails, and dynamic hip screws for fixation of intertrochanteric fractures of femur: A meta-analysis. Orthop Traumatol Surg Res 2014;100:859-66
  10. Bendo JA, Weiner LS, Strauss E, Yang E. Collapse of intertrochanteric hip fractures fixed with sliding screws. Orthop Rev 1994;(Suppl):30-7
  11. Robertson GA, Wood AM. Hip hemi-arthroplasty for neck of femur fracture: What is the current evidence? World J Orthop 2018;9:235-44
  12. Lee YK, Ha YC, Chang BK, Kim KC, Kim TY, Koo KH. Cementless bipolar hemiarthroplasty using a hydroxyapatite-coated long stem for osteoporotic unstable intertrochanteric fractures. J Arthroplasty 2011;26:6