Comparative analysis of the quality of the cement mantle in hip hemiarthroplasty after femoral neck fracture between three different surgical approaches: a single-center retrospective observational study

被引:0
|
作者
Vargas-Meouchi, Enrique A. [1 ]
Gonzalez-Morgado, Diego [1 ]
Lakhani, Kushal [1 ,2 ,3 ]
Aliaga-Martinez, Andres [1 ,2 ]
Mimendia, Inaki [1 ,2 ,4 ]
Soza, Diego [1 ,2 ,4 ]
机构
[1] Hosp Univ Vall dHebron, Orthopaed Surg & Traumatol Dept, Passeig Vall dHebron 119-129, Barcelona 08035, Spain
[2] Vall dHebron Res Inst VHIR, Reconstruct Surg Locomotor Syst Grp CRAL, Barcelona, Spain
[3] Hosp Univ Nuestra Senora Candelaria, Ctra Gral Rosario 145, Tenerife, Spain
[4] Univ Autonoma Barcelona, Dept Surg, Barcelona, Spain
来源
EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY | 2024年 / 34卷 / 08期
关键词
Direct anterior approach; Cement mantle quality; Hemiarthroplasty; Femoral neck fracture; Elderly; Hip fracture; ARTHROPLASTY; STEM;
D O I
10.1007/s00590-024-04064-9
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose Achieving the initial stability of implants is necessary for hip hemiarthroplasty (HHA), especially in elderly patients, and this can be achieved with a cement mantle of quality. The direct anterior approach (DAA) for HHA lately has shown positive results. However, evidence is lacking of HHA in elderly patients with osteoporosis after femoral neck fracture (FNF). This study compares differences in cement mantle quality after HHA, its complications, radiological outcomes and functional status in elderly patients with FNF intervened through different approaches. Methods A non-interventional, retrospective case-control study was conducted. 150 cases were selected based on the surgical approach (DAA, DLA and PLA) in a 1:1:1 proportion between 2018 and 2019. Under 75 years old suspicion or confirmation of a pathological fracture were excluded. Antibiotic-loaded cement was utilized. Cement preparation involved vacuum centrifugation and standard instructions for preparation canal and filling, and prosthesis placement were followed. Results No statistically significant differences in cement mantle quality, radiological outcomes, and the majority of the postoperative complications and functional status considering the surgical approach (p > 0.05). However, the DAA was associated significantly with shorter hospital stays (8.3 days vs 11.3 and 13 days for DLA and PLA) a decrease in postoperative blood transfusion (22% vs 34% and 53%), and lower rate of loss of walking (8% vs 20% and 28.6%). Conclusion The DAA for HHA in patients with FNF provides a high-quality cement mantle, similar to other approaches. Also, the DAA shows advantages like shorter hospital stays and lower transfusion rates in elderly patients.
引用
收藏
页码:3889 / 3895
页数:7
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