To Evaluate The Effect Of Accelerated Rehabilitation In The Perioperative Period Of Total Hip Arthroplasty For Femoral Neck Fracture In The Elderly

Background:As China's population aging process continues to accelerate,the number of elderly people is increasing,and femoral neck fractures are serious traumatic diseases that affect the health and quality of life of the elderly.Total hip arthroplasty(THA)as an effective method for the treatment of femoral neck fracture in the elderly,the surgical technique is already very mature.However,at present,the perioperative management of hip replacement in orthopedic departments of most hospitals still adopts routine rehabilitation methods,and the problem of perioperative complications has not been well solved,which has a certain impact on the smooth rehabilitation of patients after operation.With the gradual introduction of the concept of accelerated rehabilitation surgery((enhanced recovery after surgery,ERAS)in joint surgery,the perioperative management of THA patients with end-stage hip and knee disease has been greatly optimized,which not only ensures the safety of surgery,but also reduces the incidence of related complications,optimizes the perioperative treatment experience of patients,makes patients get better and faster recovery,and solves some problems existing in routine perioperative management.However,at present,the clinical application rate of ERAS in perioperative management of patients with femoral neck fracture is less,there is no unified plan,and the specific manifestations of different orthopedic subspecialties are also different,so further research is needed.Objective:Under the guidance of the concept of accelerated rehabilitation surgery,optimize the management measures before,during and after total hip replacement for elderly femoral neck fractures,compare with conventional rehabilitation treatment models,and study ERAS theory in total hip replacement for elderly femoral neck fractures Clinical application effect during perioperative period.Methods:The data of 96 elderly patients with femoral neck fracture who performed THA from the Department of Orthopedics,Huaihe Hospital,Henan University from January 2019 to December 2019 wereretrospectively analyzed.According to the different intervention methods of perioperative management of THA in patients with femoral neck fracture,they were divided into two groups: routine group(n = 47),mean age(69 ±3.6years),male group(n = 19),female group(n = 28),eras group(n = 49): mean age(68±4.5years),male group(n = 17)and female group(n = 32).The routine rehabilitation perioperative management was used in the routine group,and the accelerated rehabilitation perioperative management was used in the eras group.The Harris score of hip joint and VAS(Visual Analogue Scale/Score)pain score at different time points before operation,24 hours,2 weeks,3 months and 6 months after operation in patients with THA were collected,and the perioperative blood loss,intraoperative blood transfusion and postoperative nausea and vomiting(postoperative nausea and vomiting,PONV complications in patients with THA were collected at the same time.And summarize and analyze the data.Result:Comparing the Harris score data of hip joints in the THA patients with femoral neck fracture before operation,3 months after operation,and 6 months after operation in the conventional group and the eras group,the difference was not statistically significant(P>0.05).In the hip Harris scores of the elderly patients with femoral neck fracture at 24 hours and 2 weeks after operation,the data of the eras group were better than those of the routine group,and the difference was statistically significant(P<0.05).2.There was no significant difference in the preoperative VAS pain score between the routine group and the eras group in the preoperative VAS pain score of the elderly patients with femoral neck fracture(P>0.05).In the perioperative management of the THA patients with femoral neck fracture,the VAS pain score at 24 hours after operation,1 week and 2 weeks after operation,the VAS pain score of the eras group was better than that of the routine group,and the difference was statistically significant(P<0.05).3.In perioperative management of elderly patients with femoral neck fracture in THA group,the data of intraoperative blood loss and intraoperative blood transfusion in eras group were lower than those in routine group,and the data of hemoglobin in eras group was better than that in routine group 3 days after operation,and there was significant difference between the two groups(P<0.05).4.The number of postoperative nausea and vomiting complications in the perioperative management ofpatients in the routine group was 15 cases(31.9% in the),eras group).The number of postoperative nausea and vomiting complications in the perioperative management of patients in the conventional group was 7cases(14.3%).There was significant difference between the two groups(P<0.05).Conclusions:For the elderly patients with femoral neck fracture who received THA,accelerated perioperative rehabilitation management can more quickly restore the hip joint function of the patients with femoral neck fracture,reduce the pain during the perioperative management of THA patients with femoral neck fracture,reduce the amount of intraoperative blood loss and intraoperative blood transfusion in patients with femoral neck fracture THA,and also reduce the incidence of postoperative nausea and vomiting complications in patients with THA of femoral neck during perioperative period.So that patients can recover better and faster and improve patient satisfaction.