Comparative assessment of short term outcome of cementless prosthesis versus cemented femoral stem prosthesis in hip arthroplasty for elderly intertrochanteric fracture

YAN Wen-long; YANG Xiao-zhong; ZHANG Hua; ZHANG Jian

Abstract：Objective To compare the short-term clinical effect of the distal fixed prosthesis ( cementless prosthesis ) with cemented femoral stem prosthesis in hip arthroplasty for elderly intertrochanteric fracture .Methods Fifty-nine cases(54 cases followed-up) of unilateral intertrochanteric fracture in senile patients from Aug .2010 to Apr.2012 were retrospectively analyzed and randomly divided into 2 groups.In them,21 cases underwent hip ar-throplasty using the distal fixed prosthesis ( cementless group ) ,and the other 33 were treated with cemented hip ar-throplasty (cement group).The difference was compared in time of hospitalization , time of operation,blood loss, adverse effect,Harris scoring and radiological results .Results The average operation time were (42.3 ±7.2) mi-nutes in cementless group and (51.5 ±8.3) minutes in cement group,with significant difference (P<0.05).The blood loss were (149.9 ±27.7) ml in cementless group and(205.2 ±47.3)ml in cement group,with significant differ-ence(P<0.05).Two patients developed periprosthetic femoral fracture in cementless group .There was no signifi-cant statistical difference between two groups in time of hospitalization , total blood loss 3 days after the operation ,Har-ris scoring,complications and radiographic evaluations (including radiolucent line,osteolysis) (P>0.05).Conclu-sion Hip arthroplasty using cementless prosthesis for treatment of elder patients with intertrochanteric fracture can a -chieve good short-term clinical effect alike cemented prosthesis .It helps reduce operative time ,blood loss and bone cement implantation syndrome during the operation .The medium and long term effect still needs further research . And preoperative evaluation on the shape and size of medullary cavity and the severity of osteoporosis is needed .