Middle- and short-term follow-up of biological artificial femoral head replacement in elderly patients with proximal femoral fracture of chronic renal disease / 中国组织工程研究

ABSTRACT

BACKGROUND: Fracture of the proximal femur is common in the elderly. Biological artificial femoral head replacement is one of the main methods of surgical treatment, but in the patients with chronic renal disease, the surgical efficacy and safety are variously reported. OBJECTIVE: To analyze the middle- and short-term effects of biological artificial femoral head replacement in elderly patients with proximal femoral fracture of chronic renal disease. METHODS: Biological artificial femoral head replacement was used to treat 53 patients with proximal femoral fractures (aged 75 years and over). They were divided into two groups according to renal function chronic renal disease group (n=25) and non-chronic renal disease group (n=28). Operation time, intraoperative blood loss, intraoperative blood transfusion, postoperative drainage volume of 24 hours, and partial and complete weight-bearing time, hospitalization time, hospitalization expenses and complications were compared between the two groups. Harris hip joint function score, dual energy X-ray bone density, prosthesis loosening, periprosthetic osteolysis and implant survival rate were compared in the two groups during follow-up. RESULTS AND CONCLUSION: (1) In the non-chronic renal disease group, one patient died of respiratory failure at 1 month after replacement, and one case was refurbished at 3 months after replacement. In the chronic renal disease group, one patient died of cardiopulmonary failure at 3 months after replacement. Other patients in both groups were followed up for 1-8 years. The repair efficacy was satisfactory. (2) The excellent and good rate of hip function Harris score was 83% and 85% at 6 months after operation in chronic renal disease group and non-chronic renal disease group, respectively (P > 0.05). (3) No significant differences in operation time, blood loss, the volume of drainage 24 hours after the operation, the partial and complete weight-bearing time and dual energy X-ray bone density were determined between the two groups. The blood transfusion was larger; hospitalization time was longer; hospitalization expenses were more in the chronic renal disease group compared with the non-chronic renal disease group. (4) Patients in the two groups experienced different degrees of osteolysis, but no obvious prosthesis loosening was found. One patient in the non-chronic renal disease group underwent revision because of repeated dislocation of the prosthesis. The survival rates of the prosthesis in the chronic renal disease group and non-chronic renal disease group were 100% and 96% respectively (P > 0.05). (5) For elderly patients with proximal femoral fracture of chronic renal disease, the biological artificial femoral head replacement obtained good repair efficacy, and the function of the limbs was improved obviously with careful preoperative preparation.