| Objective: Hemiarthroplasty of hip joint is one of the major treatment for the reconstruction of the hip joint,especially for the patient who can't tolerate total hip arthroplasty.Hemiarthroplasty of hip joint has various advantages such as being less traumatic,shorter operative time,shorter recovery time post surgery and fast reconstruction of hip joint.Patients with osteoporosis has low bone mineral density,hence initially on the implantation of the femoral prosthesis there is not enough stabilty in the interface between the bone and prosthesis.This lack of stability will result in micro-motion,causing pain in the leg and resulting into loosening of the prosthesis after surgery.In patients with osteoporosis undergoing hemiarthroplasty,the treating doctors have the tendency to opt for the cemented femoral prosthesis at early stage.With the implementation of femoral prosthesis material,porous and coating technology,the cementless prosthesis can also provide satisfactory desired curative effects.The objective of this study is to evaluate the efficacy of the cement and cementless femur prosthesis in the Hemiarthroplasty of hip joint in elderly patients by a comparative study.It aim to provide some reference for the choice of prosthesis for hemiarthroplasty in patients with osteoporosis.Methods: A retrospective study of the efficacy of 105 cases of hip hemiarthroplasty from January 2012 to January 2014 was carried out.All Patients in the study who were accepted had undergone unilateral hemiarthroplasty for the first time and they were diagnosed osteoporosis by Dual-energy X-ray absorptiometry.105 patients were divided into two groups: the cement group and cementless group.There were 56 cases in the cement group,include 22 males and 34 females.Their age ranged from 60 to 79(mean age,70.05±4.91 years);Bone Mineral Density(BMD)average 0.762±0.107 g/cm2;Harris hip score before operation 59.21±6.76.36 cases were diagnosed with femoral neck fracture,9 cases were diagnosed with femoral intertrochanteric fracture and 11 cases were diagnosed with avascular necrosis.There were 49 cases in the cementless group,include 20 males and 29 females.Their age ranged from 58 to 82(mean age,69.53±5.66 years);Bone Mineral Density(BMD)average 0.773±0.076 g/cm2;Harris hip score before operation 56.69±7.32.32 cases were diagnosed with femoral neck fracture,6 cases were diagnosed with femoral intertrochanteric fracture and 11 cases were diagnosed with avascular necrosis.All patients were operated by the postero-lateral approach and they got anti-bacterial prophylactic therapy and rehabilitation exercises after surgery.The study was based on the following factors: operative time,volume of drainage,Harris hip Score(Pre and post surgery)and post-operative radiological examination(femoral component subsidence,osteolysis,severe femoral stress shielding,heterotopic ossification)during an average follow-up time of 13.6±1.4 months.This study is the comparison between the above factors between the cement and cementless groups.For the harris score we have done the comparison between pre-surgery harris score and post-surgery harris score in each individual group as well as the comparison between both group post-surgery harris score and the harris score grading.The aim of this study is to evaluate the efficacy of the cement and cementless hemiarthroplasty in patients with osteoporosis.Results:1.In the cement surgical group the operative time was found to be longer than the cementless surgical group;Statistically significant(P<0.05).2.No significant difference was detectable in the volume of post-operative drainage between the two groups(P>0.05).3.The post operative harris hip score was found higher than the pre-surgery harris hip score in both cement and cementless group;Statistically significant(P<0.05).No significant differences in the post-surgery Harris score and its grading were visible between the two groups in the average follow-up time of 13.6±1.4 months(P>0.05).4.There was no signifiant differences in the radiographic examination between the two groups in the follow-up(P>0.05).Conclusion: These results suggest that both the cement and cementles hemiarthroplasty help in the treatment of the patients with osteoporosis.The efficacy and operative wounds of cementless Hemiarthroplasty is similar to the cement Hemiarthroplasty on elderly patients with osteoporosis.When we are choosing the prosthesis for such patients the bone cement prosthesis is not the only choice.The adequate cementless prosthesis can also provide a good and satisfactory treatment for these patients.Hemiarthroplasty of patients with osteoporosis,the lowest operative time and avoiding toxic reactions of cement can be the advantageous factors of cementless prosthesis. |
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