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KMID : 1120320190050000009
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Osteoporosis and Sarcopenia
2019 Volume.5 No. 0 p.9 ~ p.9
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Functional outcome of hip arthroplasty in neck of femur fragility fracture among chronic kidney disease patients
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Punganan Gauthamen
Vinotharan Jeyaraj
Maniventhan Nachimuthu
Lee Zhi Wen
Farahani Shaiedi Nur
Manoharan Krishnan
Vijay Subramaniam
Mohan Brabaharan
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Abstract
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Introduction: Neck of femur fracture incidence among chronic kidney disease (CKD) patient is higher than in general population. Surgical treatment of neck of femur fracture in CKD patient is an ongoing challenge due to high risk of post-operative mortality and morbidity. Osteoporosis and chronic kidney disease-mineral & bone disorder (CKD-MBD) can lead to biological and mechanical failure after hip arthroplasty. No study was done to compare the functional outcome of hip arthroplasty among CKD patients who underwent hemiarthroplasty and total hip arthroplasty.
Methodology: Retrospective review of the database of orthopaedic unit was conducted from January 2015 to April 2018. Patients with CKD diagnosed with neck of femur fragility fracture who underwent hip arthroplasty (total or hemiarthroplasty) was included in the study. Patients was reviewed in the clinic and outcome of surgery was assessed using Harris Hip Score (HHS).
Results and Discussion: Total of 353 patients with neck of femur fracture underwent hip arthroplasty (total and hemiarthroplasty of hip) from January 2015 to April 2018.32 patients (9.1%) had underlying CKD. At the time of assessment of HHS, only 11 (34.38%) patients were alive (21 patient died). 76% of patients died within 1-year post-hip arthroplasty surgery. 40% of patient showed poor result (HHS score <70) post hip arthroplasty. All the patients who had poor result were underwent cemented hemiarthroplasty of the hip. 50% of patient who had good and excellent result underwent total hip replacement.
Conclusion: No major difference was seen in the functional outcome of patient with CKD who underwent hemiarthroplasty or total hip arthroplasty. A multicentered prospective study needs to be done to compare the functional outcome of CKD patients after total hip replacement and hemiarthroplasty considering the bone quality of proximal femur and acetabulum in order to design a protocol of surgical intervention in this special elderly group of patients.
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KEYWORD
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