Chinese Journal of Tissue Engineering Research ›› 2016, Vol. 20 ›› Issue (17): 2503-2510.doi: 10.3969/j.issn.2095-4344.2016.17.010

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Different orthopedic implants for repairing elderly patients with hip diseases: complications and death factors

Chen Xiang-xu, Wang Chen, Lin Yu-cheng, Wang Shan-zheng, Zhang Xue-jun   

  1. Department of Orthopedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China
  • Received:2016-01-28 Online:2016-04-22 Published:2016-04-22
  • Contact: Wang Chen, Professor, Master’s supervisor, Chief physician, Master, Department of Orthopedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China
  • About author:Chen Xiang-xu, Studying for master’s degree, Department of Orthopedics, Zhongda Hospital, Southeast University, Nanjing 210009, Jiangsu Province, China

Abstract:

BACKGROUND: Elderly patients with hip surgery in the department of orthopedics are often associated with a variety of diseases, and easily suffer from complications after implantation. 

OBJECTIVE: To analyze the characteristics and the factors of complications and mortality of the elderly patients with hip disease by different orthopedic implants.
METHODS: 249 patients accepted total hip arthroplasty, femoral head replacement, proximal femoral nail, Gamma nail, and hollow screw fixation. We analyzed patients’ age, sex, hip disease type, anesthesia risk assessment, psychological and psychiatric factors, admission hemoglobin, preoperative albumin, Charlson comorbidity index, ways of anesthesia, orthopedic implants, operation time, intraoperative bleeding, length of stay, postoperative complications, mortality and survival.
RESULTS AND CONCLUSION: Hip disease in the elderly was repaired with five kinds of implants. (1) There were significant differences in age, anesthesia risk assessment, hemoglobin on admission and preoperative albumin, length of stay, duration and intraoperative bleeding. No significant difference in complications and death was found. (2) The most significant indicators affecting complications were length of stay and albumin on admission and preoperative Charlson comorbidity index. The most significant indicators affecting death were age and hemoglobin on admission and preoperative Charlson comorbidity index. (3) Significance of comprehensive assessment of patients before placement: during hip operation, implants were not the factors that affected the complications and mortality after placement, patients with artificial joint replacement could get out of bed early, and complications and mortality could be reduced. Elderly patients with anemia, hypoalbuminemia and Charlson comorbidity index ≥3 should be given a high degree of attention. We should assess Charlson comorbidity index as early as possible, positively treat complications, correct anemia and hypoproteinemia, prevent the occurrence of complications, shorten the length of hospital stay, and reduce the mortality after placement.
中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程

Key words: Aged, Hip Joint, Prostheses and Implants, Tissue Engineering