Abstract:

BACKGROUND: Non-cemented prosthesis is commonly considered applicable for patients < 65 years, and cemented prosthesis for elderly patients with poor bone condition. However, there is no evidence that non-cemented prosthesis cannot be used for patients aged > 70 years, who are healthy, able to do daily activity, with no osteoporosis or with mild osteoporosis.

OBJECTIVE: To evaluate the clinical effect of premiere non-cemented total hip arthroplasty in elderly patients.

METHODS: A total of 57 cases (65 hips) of elderly patients, aged > 70 years, with an average age of 86.3 years, underwent primary total hip arthroplasty with non-cemented prosthesis, including 33 cases (33 hips) of femoral neck fractures, 18 cases  (25 hips) of femoral head avascular necrosis, and 6 cases (7 hips) of developmental dysplasia of hip. The operation time, blood loss, hospitalization time, beginning time of getting out of bed postoperation, Harris score, X-ray result, complications in 3, 6, 12 and 24 months postoperatively.

RESULTS AND CONCLUSION: The follow-up time ranged from 6 to 40 months postoperation, with an average time of 19.6 months. A total of 53 patients were followed up and 4 cases were lost after 1 year postoperatively. No prosthesis loosening was observed, and no cases required reoperation. Harris score was increased from average 40.7±18.9 preoperatively to 89.2 ±5.5 postoperatively, with an excellent and good rate of 93.7%. Wound hematoma, cerebral vascular accident and urinary tract infection were respectively observed in 1 case. Elderly patients treated with non-cemented prosthesis in primary total hip arthroplasty obtained satisfactory short-term clinical outcomes.