Efficacy and influencing factors of primary total hip arthroplasty in elderly patients with femoral neck fracture / 局解手术学杂志

ABSTRACT

Objective To evaluate the efficacy of primary total hip arthroplasty(THA) in elderly patients with femoral neck fracture and explore its influencing factors.Methods The clinical data of 84 elderly patients with femoral neck fracture from January 2013 to January 2016 in Second Affiliated Hospital of Hainan Medical College hospital who received the primary THA was retrospectively analyzed.The age,gender,body mass index (BMI),fracture type,bone mineral density,preoperative complication,methods of anesthesia,surgical approach,operation time,the amount of intraoperative bleeding,drainage condition,recessive blooding,limb length changes,postoperative rehabilitation exercise time,pain management and psychological intervention were collected,and the Harris score was recorded in 1 year follow-up to evaluate the joint function.Firstly,univariate analysis was used to find out the influencing factors of the hip joint function from the above information,then Harris score as dependent variable by logistic regression analysis was used to determine the independent influencing factors.Results The Harris score at postoperative 1 year showed that24 cases were excellent,42 cases were good,13 cases were fair,5 cases were poor,the excellent and good rate was 78.6％.The univariate analysis results showed that BMI,bone mineral density,method of anesthesia,surgical approach,recessive bleeding,limb length changes,postoperative rehabilitation exercise time and postoperative pain management had significance difference in hip joint function of different patients(P ＜ 0.05).Multivariate logistic regression analysis showed that BMI,bone mineral density,method of anesthesia,surgical approach,recessive bleeding,limb length changes,postoperative rehabilitation exercise time,postoperative pain management were independent factors of hip function after primary THA for femoral neck fracture in the elderly(P ＜ 0.05).Conclusion The efficacy of primary THA for the femoral neck fractures in elderly patients is significant.BMI,bone mineral density,method of anesthesia,surgical approach,recessive bleeding,limb length changes,postoperative rehabilitation exercise time,postoperative pain management are independent factors affecting the efficacy,which should be given enough attention.