A Comparative Assessment Of Short-Term Outcomes Of Corail Entirely Hydroxyapatite-Coated Versus Cemented Femoral Stem Prosthesis In Total Hip Arthroplasty For Elderly Femoral Neck Fracture

Objective:To compare the short-term clinical effect of Corail entirely hydroxyapatite(HA)-coated versus cemented femoral stem prosthesis in total hip arthroplasty(THA) for elderly femoral neck fracture(FNF), in order to provide reference for improve the clinical efficacy in artificial hip joint arthroplasty for FNF in elderly patients.Methods:54 cases with unilateral FNF over 75 between January 2007 to June 2008 were retrospectively analyzed. Out of these, 21 cases underwent THA using Corail femoral prosthesis(HA group), and the other 33 were treated with cemented THA(cement group). The difference was compared in time of hospitalization, time of operation, blood loss , hemodynamic parameters, adverse effect, Harris score and radiological results.Results:1.All patients were in good condition during the operation. The average follow-up time were 9.5 months and 9.8 months respectively, no case died or received revision.2.The average operation time were 52.6±7.2 minutes in HA group and 62.5±8.5 minutes in cement group, with significant differences(P<0.05). The blood loss was 217.9±37.7 mL in HA group and 250.2±57.3 mL in cement group, with significant differernces(P<0.05).3.At the moment when infusing the cement, the systolic blood pressure(SBP) and diastolic blood pressure(DBP) decreased significantly maintained for 5～10 minutes, and recovered after 10 minutes. At 3 minutes after infusing the cement, the heart rate(HR) changed rapidly, and recovered after 5～20 minutes. But the hemodynamic parameters showed no significant change in HA group.4.There were no significant statistical differences between two groups in time of hospitalization, blood transfusion volume, complcations, Harris score and radiographic evaluations(including radiolucent line, osteolysis, prosthetic loosening and subsidence ).Conclusion:1.Compared with cemented femoral stem prosthesis,THA using entirely Corail HA-coated femoral stem prosthesis for treatment of elder patients with FNF can be effectively performed without increased risk of complications. Significant benefits of entirely Corail HA-coated femoral prosthesis include less operation time, blood less and inhibition effect on myocardial contraction and peripheral vascular function during the operation.2.Strictly appraising the operative indications, standardizing the operative proceesses, systemic rehabilitation training will remarkable improve the clinical results of THA for elderly FNF .