Comparison Of Curative Effect Between Old And Very Old Patients With Femoral Neck Fracture Undergoing Cemented Hemiarthroplasty

Background: Cemented arthroplasty is an effective method in treatment of osteoporotic femoral neck fracture.Use of bone cement during arthroplasty can cause bone cement implantation syndrome.Objective: Observe the Perioperative and follow-up related indicators in patients who Comparison of the curative effect be tween elderly(60-79 years)and very elderly(≥80 years)patients who suffered femoral neck fracture and treated with cemented hemiarthroplasty.Methods : A retrospective analysis was made on the clinical data of 78 patients(78 hips)with displaced femoral neck fractures who underwent cemented hemiarthroplasty for the treatment of femoral neck fractures between January 2012 and June 2015.Patients were divided into 2 groups: the old age(60-79 years)and very old age groups(≥85 years).Records of patients’ operative duration,intraoperative blood loss,hospital stay time,perioperative morbidity and mortality.Systolic pressure,diastolic blood pressure and heart rate were recorded at the following time points: before the cement insertion,after cement insertion 0 min,5 min,10 min,and the end of operation.All patients were follow-up with 6-36 months(average 18 months).Morbidity and mortality were recorded at follow-up,and use Harris’ score to assess postoperative hip joint function recovery.Compare two groups of perioperative and follow-up observation respectively.Results: Two groups of operation duration,intraoperative blood loss,hospital stay time and perioperative morbidity had no statistical difference(P >0.05).patients with perioperative death 2(3.92%),and no perioperative death patients with elderly.Two groups are obvious fluctuations in systolic pressure,diastolic blood pressure and heart rate between the after cement insertion 0 min and the end of operation(P <0.05).Systolic and diastolic blood pressure in patients falling to a low level after cement insertion 0-5 min,a slight recovery after 10 min,and recovered to preoperative levels at the end of operation.Average heart rate in patients significantly faster after cement insertion 0-5 min,decline after 10 min and dropped to preoperative levels at the end of surgery.Two groups of Hemodynamic parameters have no statistical difference before cement insertion(P>0.05);after cement insertion,the Very elderly group of systolic blood pressure drop is greater than the elderly group(P<0.05).Although Very elderly group are lower diastolic blood pressure and faster heart rate than those of elderly group,but no statistical differences(P>0.05).Two groups of follow-up morbidity,mortality and Harris’ score had no statistical difference(P>0.05).Conclusions: Cemented arthroplasty in treatment with elderly and very elderly patients who suffered with osteoporotic femoral neck fracture can obtain good effect in early functional recovery.The higher the patients age,cement insertion easy to cause more severe hemodynamic fluctuations,increasing patients perioperative mortality risk.Careful hemodynamic monitoring and active adoption of effective measures Intraoperative in very elderly patients undergoing cemented hemiarthroplasty,can reduce hemodynamic fluctuations possibly.