Résumé
BACKGROUND:The number of elderly patients with hip fracture is huge, and this population mainly combines with a variety of internal diseases. The general condition was bad. Compared to total hip arthroplasty, bipolar hemiarthroplasty can shorten operation time, reduce the time of anesthesia and improve surgical safety, but the operation using which fixation mode is always controversial. OBJECTIVE:To compare the safety and curative effects of bipolar hemiarthroplasty with cementless or cement femoral stem prosthesis in elderly patients with osteoporotic complex hip fracture. METHODS:From June 2007 to June 2010, 198 elderly patients with osteoporotic hip fracture aged more than 75 years old, who were treated with bipolar hemiarthroplasty in the People’s Hospital of Xinjiang Uygur Autonomous Region, China, were enroled in this study. Al patients were divided into cementless group (n=69) and cement group (n=129) according to the type of prognosis. Osteoporosis was treated conventionaly in both groups after replacement. Operation time, intraoperative blood loss, incidence of postoperative hip pain, out of bed activity time post surgery, Harris scores of last folow-up and loosening rate of the prognosis were compared between the two groups. RESULTS AND CONCLUSION:176 of above 198 cases were folowed up for 48 to 84 months, including 122 in the cement group and 54 in the cementless group. Operation time was longer in the cement group than in the cementless group, but out of bed time was earlier in the cement group than in the cementless group post surgery, and there were significant differences (P 0.05). The incidences of loosening rate were 5% and 4% in the cement and cementless groups, respectively, which showed significant differences (P< 0.05). These results indicate that bipolar hemiarthroplasty with or without cement for osteoporotic hip fracture in the elderly can obtain good middle- and long-term effects. Bipolar hemiarthroplasty with cement can reduce the out of bed time, but operation time was longer, and incidences of hip pain and loosening were higher in cement prosthesis than in cementless prosthesis.