7. ĐÁNH GIÁ KẾT QUẢ THAY KHỚP HÁNG BÁN PHẦN CÓ CEMENT ĐIỀU TRỊ GÃY VÙNG MẤU CHUYỂN PHÂN ĐỘ A2 THEO AO Ở BỆNH NHÂN ≥75 TUỔI LOÃNG XƯƠNG TẠI BỆNH VIỆN CHẤN THƯƠNG CHỈNH HÌNH NGHỆ AN TỪ THÁNG 1/2019 ĐẾN THÁNG 12/2023

Abstract

Introduction: Fracture of the femoral neck (GVMCXĐ) is a fairly common injury, especially in elderly individuals. Partial hip replacement with cement improves early mobility, is more cost-effective, but carries higher surgical risks compared to the cementless group. We conducted this study with the aim of evaluating the outcomes of cemented hemiarthroplasty for treating AO type A2 intertrochanteric fractures in patients aged ≥ 75 with osteoporosis.

Subjects and Methods: This is a retrospective descriptive study involving 437 patients diagnosed with femoral neck fractures (AO classification A2), aged ≥ 75 years, with osteoporosis, who underwent cemented partial hip replacement surgery from January 2019 to December 2023. Hip function was evaluated at 6 months post-surgery using the Harris Hip Score.

Results: A total of 437 patients (126 males, 311 females) aged between 75 and 103, with a mean age of 86.2, were included in this study. Of these, 75.51% had comorbidities, with hypertension being the most common (58.58%). The average surgery duration was 54.5 minutes, the mean blood transfusion volume was 255 ml, and the average hospital stay was 15.9 days. There were five cases of hip dislocation, all of which were successfully reduced without recurrence. Eleven patients experienced periprosthetic fractures due to slips during walking, all of which underwent successful fracture fixation with good healing outcomes at six months. Four patients developed superficial infections, treated with debridement and antibiotics, while one patient with a deep infection required prosthesis removal, insertion of a cement spacer, and later conversion to total hip replacement after stabilization. All patients are now stable. There were no intraoperative deaths, though two patients passed away within 14 days post-surgery due to pulmonary embolism. At the 6-month follow-up, 412 patients (the remaining 23 were lost to follow-up for various reasons) had a mean Harris Hip Score of 76.4 (with the "average" category being the most common at 48.13%), comparable to international studies.

Conclusion: Cemented hemiarthroplasty is a relatively safe and effective treatment option with low cost for patients aged ≥75 with AO type A2 femoral intertrochanteric fractures and osteoporosis. This method facilitates early functional recovery, reduces the risk of complications, and enables patients to quickly return to daily life.