KMID : 1028220200320030148
|
|
Hip & Pelvis 2020 Volume.32 No. 3 p.148 ~ p.155
|
|
Clinical Outcomes of Total Hip Arthroplasty for Displaced Femoral Neck Fractures in Patients 80 Years of Age and Older Selected by Clinical Frailty Score
|
|
Jo Sueng-Hwan
Lee Se-Hwan Yoon Sun-Jung
|
|
Abstract
|
|
|
Purpose: The utility of total hip arthroplasty (THA) for the treatment of displaced femoral neck fractures in elderly patients (¡Ã80 years of age) remains controversial as a patient's general condition is an essential factor impacting recovery. This study aims to determine if THA is a valuable option for appropriately selected elderly patients.
Materials and Methods: All patients underwent cementless THA using a direct lateral approach with a rectangular stem. Eighty-two patients ¡Ã80 years of age underwent THA due to a displaced femoral neck. Clinical frailty scale (CFS) scores <5 were indicated for THA. The modified Harris hip score (mHHS), visual analogue scale (VAS), and patient satisfaction were used to assess outcomes.
Results: Nine of 82 patients died in the study period with another underlying disease. One, a 90-year-old male with pneumonia expired in the intensive care unit at 7-day postoperatively, while the other eight died due to causes unrelated to THA. Of the remaining 73 patients: (i) mean mHHS score increased to 80.57¡¾21.36 at 1-year postoperatively; (ii) VAS was 2.3¡¾0.9 points six-months postoperatively; and (iii) 78.7% of patients reported that they were very satisfied or satisfied 1-year postoperatively. The number of perioperative complications was 10.8% (9 hips) without the need for revision surgery.
Conclusion: The use of THA in patients ¡Ã80 years of age with low CFS scores (<5) described here yielded favorable results and a relatively low rate of complications. However, a well-controlled comparative study or randomized trial is required to further refine selection criteria for THA in this patient population.
|
|
KEYWORD
|
|
Femoral neck fractures, Osteoporosis, Elderly, Total hip replacement, Frailty
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|