The application value of artificial biological prosthesis in hemiarthroplasty for femoral neck fractures in the elderly

ZHU Tengfei; DUAN Wenbo; QIN Zhengbing

doi:10.3969/j.issn.1674-666X.2024.04.004

Abstract：Objective To explore the application value of artificial biological prosthesis in the treatment of femoral neck fractures in elderly patients undergoing hemiarthroplasty. Methods A retrospective analysis was conducted on the clinical data of 71 elderly patients with femoral neck fractures who underwent hemiarthroplasty at Zhoukou Orthopedic Hospital from July 2021 to June 2023. The patients were divided into two groups based on the type of prosthesis,in which 35 patients in the control group received cemented femoral heads,while 36 patients in the observation group received biological femoral heads. The perioperative indicators,visual analog scale (VAS) scores,and Harris hip scores were evaluated for both groups,the complications during the operation,after the operation and during the follow-up were recorded,the differences in serum stress response indicators[C-reactive protein (CRP),cortisol (COR),tumor necrosis factor alpha (TNF-α)]before and after surgery were compared between the two groups. Results Im the observation group,the operation duration was shorter,and the time for the first postoperative weight-bearing was later than those in the control group (P<0.05). VAS scores in the observation group at 1 week after the surgery were lower than those in the control group,and the levels of serum CRP,COR,and TNF-α at 1 d after the surgery were also lower than those in the control group (P<0.05). As for intraoperative blood loss,time to the first postoperative ambulation,length of hospital stay,as well as Harris scores at various postoperative time points,there were no statistical differences between the two groups (P>0.05). During the operation,no surgical related complications occurred in the observation group,while in the control group,there were 4 cases with toxic and side effects of bone cement. The difference of total rate of complications between two groups showed no statistical significance (P>0.05). Conclusions For elderly patients with femoral neck fractures who undergoing hemiarthroplasty,both biological and cemented prostheses could achieve good short-term outcomes with relief of pain and improvement of hip joint function. However,compared to cemented prostheses,biological prostheses in hemiarthroplasty have advantages of shorter operation time,minimal trauma,less pain and no complications of bone cement toxicity.