Cujilema-Cujilema JM, Palacio-Villegas JC, Stangl-Herrera WP, Echeverry-Vélez AA, Cantor E, Ron-Translateur T, Correa-Valderrama A

Language: Spanish
References: 21
Page: 241-246
PDF size: 127.21 Kb.

ABSTRACT

Introduction: Bipolar hemiarthroplasty is an alternative for the treatment of displaced femoral neck fractures in elderly patients with low functional demand and associated comorbidities. The goal was to describe functionality in patients over 65 years of age with intracapsular fractures of the hip. Material and methods: Retrospective review of patients over 65 years of age between January 2012 and May 2017. It was evaluated with the Harris Hip Score (HHS) and Oxford scale at six months and the year after surgery. Complications and mortality were documented during the first post-surgical year. Results: 48 cases (12 men; 36 women), average age of 80.8 ± 7.7 years. Most common diseases: high blood pressure (77.1%), osteoporosis (37.5%), diabetes (33.3%) hypothyroidism (29.2%). The percentage of associated postoperative complications was 8.3% (four cases). The median HHS at six and 12 months was: 90.5 (DE: 77.5-96.0) and 96 (DE: 92-98), respectively. The Oxford scale was 45.5 (DE: 38.5-48.0) at six months and 47.0 (DE: 43.5-48.0) per postoperative year. 4.2% (two cases) died during the first post-surgical year and none were associated with the procedure. Discussion: HA provides good functional outcomes in patients over 65 years of age, with a low rate of complications. No mortality associated with the surgical procedure was observed in our series and in the short term.

REFERENCES

1. Ma R, Gu G, Wang CX, Zhu D, Zhang X. Relationship between surgical time and postoperative complications in senile patients with hip fractures. Chin J Traumatol. 2010; 13(3): 167-72.

2. González LA, Vásquez GM, Molina JF. Epidemiología de la osteoporosis. Rev Colomb Reumatol. 2009; 16(1): 61-75.

3. González ID, Becerra MC, González J, Campos AT, Barbosa SJ, Alvarado SJ. Fracturas de cadera: satisfacción posquirúrgica al año en adultos mayores atendidos en Méderi-Hospital Universitario Mayor, Bogotá, D.C. Ciencias la Salud. 2016; 14(3): 411-24.

4. Henderson CY, Ryan JP. Predicting mortality following hip fracture: an analysis of comorbidities and complications. Ir J Med Sci. 2015; 184(3): 667-71.

5. Vertelis A, Robertsson O, Tarasevicius S, Wingstrand H. Delayed hospitalization increases mortality in displaced femoral neck fracture patients. Acta Orthop. 2009; 80(6): 683-6.

6. Van Embden D, Rhemrev SJ, Genelin F, Meylaerts SAG, Roukema GR. The reliability of a simplified Garden classification for intracapsular hip fractures. Orthop Traumatol Surg Res. 2012; 98(4): 405-8.

7. Zlowodzki M, Bhandari M, Keel M, Hanson BP, Schemitsch E. Perception of Garden’s classification for femoral neck fractures: an international survey of 298 orthopaedic trauma surgeons. Arch Orthop Trauma Surg. 2005; 125(7): 503-5.

8. Navarro CM, Peiró MS, Ruiz JL, Payá RA, Hervás JM, López MP. Validez de la escala de cadera de Harris en la rehabilitación tras artroplastia de cadera. Rehabilitacion. 2005; 39(4): 147-54.

9. Weel H, Lindeboom R, Kuipers SE, Vervest TMJS. Comparison between the Harris- and Oxford Hip Score to evaluate outcomes one-year after total hip arthroplasty. Acta Orthop Belg. 2017; 83(1): 98-109.

10. Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br. 1996; 78(2): 185-90.

11. Magaziner J, Hawkes W, Hebel JR, Zimmerman SI, Fox KM, Dolan M, et al. Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci. 2000; 55(9): M498-507.

12. Yurdakul E, Karaaslan F, Korkmaz M, Duygulu F, Baktır A. Is cemented bipolar hemiarthroplasty a safe treatment for femoral neck fracture in elderly patients? Clin Interv Aging. 2015; 10: 1063-7.

13. Veldman HD, Heyligers IC, Grimm B, Boymans TA. Cemented versus cementless hemiarthroplasty for a displaced fracture of the femoral neck. Bone Joint J. 2017; 99B(4): 421-31.

14. Vochteloo AJ, Niesten D, Riedijk R, Rijnberg WJ, Bolder SB, Koter S, et al. Cemented versus non-cemented hemiarthroplasty of the hip as a treatment for a displaced femoral neck fracture: design of a randomised controlled trial. BMC Musculoskelet Disord. 2009; 10(1): 56.

15. Burgers PT, Van Geene AR, Van den Bekerom MP, Van Lieshout EM, Blom B, Aleem IS, et al. Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis and systematic review of randomized trials. Int Orthop. 2012; 36(8): 1549-60.

16. Murena L, Fattori R, Scamacca V, Cau P, Ratti C, Canton G. Treatment of intracapsular fractures of the proximal femur with bipolar hemiarthroplasty in patients under the age of 70: clinical and radiographic results at mean 20 years follow-up. Acta Biomed. 2016; 87(Supp 1): 53-9.

17. Hopley C, Stengel D, Ekkernkamp A, Wich M. Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ. 2010; 340: c2332.

18. Grosso MJ, Danoff JR, Murtaugh TS, Trofa DP, Sawires AN, Macaulay WB. Hemiarthroplasty for displaced femoral neck fractures in the elderly has a low conversion rate. J Arthroplasty. 2017; 32(1): 150-4.

19. Keating JF, Grant A, Masson M, Scott NW, Forbes JF. Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty. Treatment of displaced intracapsular hip fractures in healthy older patients. J Bone Joint Surg Am. 2006; 88(2): 249-60. Available in: http://0-jbjs.org.innopac.lsuhsc.edu/content/88/2/249.abstract.

20. Zhang C, Wang X, Ma X, Xia J, Huang J, Jiang J. Hemiarthroplasty versus total hip arthroplasty for displaced femoral neck fractures: a meta-analysis of the literature. Vol. 7, Asian Biomedicine. 2013. p. 635-48.

21. Wang F, Zhang H, Zhang Z, Ma C, Feng X. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis. BMC Musculoskelet Disord. 2015; 16(1): 16:229.