COMPARISON OF THE EFFICACY OF BIOLOGICAL FEMORAL STEM AND BONE CEMENT FEMORAL PROSTHESIS IN THE TREATMENT OF FEMORAL NECK FRACTURES IN ELDERLY PATIENTS WITH OSTEOPOROSIS

Wei Chen, Jinxin Zheng, Yancheng Xiu, Shuzhang Guo^*

Department of Orthopedics, Tianjin Third Central Hospital

Introduction: To compare and observe the clinical effects of total hip arthroplasty with biological femoral prosthesis and total hip arthroplasty (THA) with bone cement femoral prosthesis in elderly patients with osteoporotic femoral neck fracture. 

Materials and methods: A total of 62 elderly patients with osteoporotic femoral neck fractures were divided into a bone cement type group and a biological-type group according to the different fixation methods of the prosthesis femoral stem, 31 cases in each group. Both groups were treated with femoral head replacement. The patients in the bone cement type group were treated with bone cement prosthesis implantation, and the patients in the biological group were treated with biological prosthesis implantation during the operation. The surgery-related indexes, postoperative hip function (Harris), pain condition (visual analogue scale/score, VAS), imaging evaluation results, and complications were compared between the two groups. 

Results: The results showed that the operation time in the biological group was shorter than that in the bone cement group, and the amount of bleeding was less than that in the bone cement group (P<0.05). While the landing time in the bone cement group was longer than that in the biological group (P<0.05). After operation, the patients were evaluated for hip function (Harris score) and pain assessment (VAS score). It was found that the Harris score of bone cement group was higher than that of biological group one month after operation (P<0.05), but there was no significant difference between the two groups at 3, 6 and 12 months of follow-up, while the pain in the biological group was slightly relieved than that in the bone cement group (P<0.05). There was no significant difference in the cure rate of osteoporotic femoral neck fracture between the two groups, but the incidence of complications in the bone cement group was higher than that in the biological group (P<0.05). 

Conclusions: For elderly patients with osteoporotic femoral neck fracture, artificial hip arthroplasty with different prostheses can achieve good early curative effect, effectively reduce bed rest time and complications, and improve the quality of life of patients. The appropriate prosthesis can be selected according to the patient's physical condition.