Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis - Comparative Analysis between Cementless Stem and Cemented Stem -

Joon Soon Kang; Kyoung Ho Moon; Rhu Seop Kim; Sang Ho Lee; Jong Min Choi

doi:10.12671/jkfs.2011.24.1.16

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Kang, Moon, Kim, Lee, and Choi: Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis - Comparative Analysis between Cementless Stem and Cemented Stem -

Original Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2011; 24(1): 16-22.

Published online: 19 January 2011

DOI: https://doi.org/10.12671/jkfs.2011.24.1.16

Usefulness of the Cementless Stem for the Treatment of Hip Fracture in Elderly Patients with Osteoporosis - Comparative Analysis between Cementless Stem and Cemented Stem -

Joon Soon Kang, M.D., Kyoung Ho Moon, M.D., Rhu Seop Kim, M.D., Sang Ho Lee, M.D., Jong Min Choi, M.D.

Department of Orthopaedic Surgery, College of Medicine, Inha University, Inchon, Korea.

Address reprint requests to: Rhu Seop Kim, M.D. Department of Orthopaedic Surgery, College of Medicine, Inha University, 7-206, Sinheung-dong 3-ga, Jung-gu, Inchon 400-711, Korea. Tel: 82-32-890-2380·Fax: 82-32-890-3047, keelimg@gmail.com

Received 15 July 2010 Revised 3 September 2010 Accepted 8 November 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We evaluated the usefulness of the cementless stem in treating hip fracture patients older than 70.

Materials and Methods

We studied elderly osteoporotic hip fractures in the neck and intertrochanter area who had received hip arthroplasty with over 2 years of follow up period. Among those, we analyzed the clinical and radiological results of hip arthroplasty with cemented stem (group 1) and hip arthroplasty with cementless stem (group 2). Each group was consists of fifty hips.

Results

The mean age at surgery was 75 years and mean follow-up period was 40 months (minimum 24 months). The admission period was 28.68±8.8 days for group 1 and 28.05±8.7 days for group 2 (p>0.05) and the average operation time was 87±21.2 minutes, and 80±17 minutes (p>0.05) and the total blood loss was 611±141.3 cc and 557±120.5 cc (p>0.05) respectively. There was no statistically significant difference in all aspects. One case of pulmonary embolism occurred in group 1. Stem loosening was not observed in both groups at the last follow-up radiologic study.

Conclusion

The hip arthroplasty with cementless stem for the osteoporotic hip fractures showed a competent results clinically and radiologically in short term follow up as compared with the cemented stem.

Keywords: Hip fracture, Arthroplasty, Cementless stem, Cemented stem

Figures and Tables

Fig. 1

Zweymuller stem (Plus Orthopaedics, Rotkreuz, Switcherland).

Fig. 2

Cross section of metaphysio-diaphyseal junction of femur implanted with Zweimuller stem.

Fig. 3

A 82 years old had the bipolar hemiarthroplasty with Zweymuller stem for the femur neck fracture. Radiography at post operative 4 years showed well fixation of the stem without subsidence.

Fig. 4

A 86 years old patient who diagnosed pulmonary embolism after bipolar hemiarthroplasty with using cemented stem. At post op two day, the patient complained dyspnea. Pulmonary embolism was confirmed by CT and lung perfusion scan.

Table 1

Patients demographics

Table 2

ASA classification

Table 3

Clinical results

Table 4

Koval's ambulatory ability

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