SuperPATH approach for hip replacement for femoral neck fractures in elderly patients: a short-term follow-up

doi:10.3969/j.issn.2095-4344.1997

Abstract

Abstract:

BACKGROUND: The study of minimally invasive hip arthroplasty has been a hotspot, and SuperPATH approach has gradually been considered as a real minimally invasive technique, but there is still no long-term follow-up study on the clinical efficacy of this approach.

OBJECTIVE: To explore short-term follow-up results of SuperPATH approach for hip replacement in the treatment of femoral neck fractures in elderly patients.

METHODS: From January 2016 to February 2018, 78 elderly patients with femoral neck fractures were treated with SuperPATH approach for hip replacement in Jintan Hospital Affiliated to Jiangsu University. There were 36 males and 42 females aged from 75 to 86 years old with an average age of 82.4 years old. Fractures were classified according to Garden classification, including 52 cases of type Garden Ⅲ and 26 cases of type Garden Ⅳ. Surgical risk was evaluated before operation. Totally 30 patients received total hip arthroplasty and 48 patients received prosthetic replacement. Bioprosthesis was used in 58 cases and cement prosthesis in 20 cases. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. Hip joint functions of patients with different age period, Garden classification, hip replacement type, and prosthesis type were evaluated by using Harris score.

RESULTS AND CONCLUSION: (1) Seventy-six patients were followed up from 13 to 38 months. According to Harris score, 22 cases were excellent, 50 cases were good and 4 cases were average in the final follow-up. The excellent and good rate was 95%. (2) In the final follow-up, Harris score was (86.91±1.03) in patients aged from 75 to 79 years old, (84.02±2.26) in patients aged more than 80 years old, and had significant differences between two groups (t=6.730, P=0.000). (3) In the final follow-up, Harris score was (85.33±4.21) in the Garden Ⅲ group, and (85.05±3.29) in the Garden Ⅳ group, and there was no significant difference between two groups (t=2.875, P=0.247). (4) In the final follow-up, Harris score was (83.19±5.24) in the prosthetic replacement group, and (82.75±4.88) in the total hip replacement group, and there was no significant difference in Harris score between the two groups (t=1.525, P=0.108). (5) Harris score was (82.34±6.24) in the cement prosthesis group, and (82.69±5.79) in the uncemented prosthesis group, and there was no significant difference in Harris score between the two groups (t=2.978, P=0.219). (6) During follow-up, one patient occurred hip joint dislocation on the operation side due to fall, and no dislocation occurred again after manual reduction. (7) Through long-term follow-up, treatment of femoral neck fracture in elderly patients by SuperPATH approach for hip arthroplasty can obtain good therapeutic effect. Furthermore, there was no significant difference in efficacy between patients with different Garden classification, hip replacement type, and hip prosthesis type. It shows that the approach has obvious advantages in minimally invasive and has a good application prospect.

Key words: hip arthroplasty, femoral head replacement, total hip replacement, SuperPATH approach, femoral neck fracture, minimally invasive, Garden classification

CLC Number:

R459.9|R318|R687.4

Zhang Xing, Xu Zhonghua, Xie Hua, He Jin, Zhu Aiping, Zhao Yinbi. SuperPATH approach for hip replacement for femoral neck fractures in elderly patients: a short-term follow-up[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(36): 5777-5781.

Figures/Tables 3

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