[Comparison of clinical outcome between cemented and biological femoral prosthesis for the treatment of senile femoral neck fracture].

OBJECTIVE: To study and compare the early fixed effect and mortality for cemented and biological femoral prosthesis in treatment of senile osteoporotic femoral neck fracture, and investigate the prosthesis choice in hip arthroplasty.

METHODS: From January 2012 to December 2014, 130 patients(130 hips) with osteoporotic femoral neck fracture were treated by hemiarthroplasty. According to the operation method the patients was divided into two groups: 72 cases in cemented group included 26 males and 46 females with an average age of (82.0±6.5) years old, 32 cases were Garden III and 40 cases were Garden IV, the average time from injury to operating was(5.5±3.3) days; 58 cases in biological group included 19 males and 39 females with an average age of(80.1±6.7) years old, 21 cases were Garden III and 37 cases were Garden IV, and the average time from injury to operating was(5.4±2.1) days. Every patients were suffering from hip swelling, tenderness, axial taps lower limb pain and joint activities obstacles. ASA grade evaluation, heart function assessment, surgical treatment and postoperative follow-up effectively performed after admission. The operation duration, intraoperative blood loss, hospital stay, rate of complications, mortality, residual pain (VAS score) and hip function (Harris score) of two groups were observed and compared.

RESULTS: Biological group received shorter operation time and less intraoperative blood loss than cemented group( P <0.05). Perioperative mortality was 2.7%(2 patients) in cemented group, and no one death in biological group. Finally, 128 patients were follow-up for an average of 22 months. Complications and VAS score of cemented group was lower than that of biological group during follow-up( P <0.05), but Harris score was higher ( P <0.05). There was no statistical difference in mortality between two groups during follow-up period( P >0.05).

CONCLUSIONS: The early fixed effect for the cemented prosthesis used in treatment of senile osteoporotic femoral neck fracture is better than biological stem. Some patients who with higher ASA grade or poor cardiopulmonary function can choose biological prosthesis in order to reduce perioperative mortality.