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. 2017 Sep-Oct;25(5):220-223.
doi: 10.1590/1413-785220172505167473.

COMPLICATIONS AND MIDTERM OUTCOMES OF HEMIARTHROPLASTY IN HEMODIALYSIS PATIENTS

Ahmet Salduz  1 , Gökhan Polat  1 , Turgut Akgül  1 , Omer Naci Ergin  1 , Koray Şahin  1 , Önder Yazicioğlu  1
Affiliations

COMPLICATIONS AND MIDTERM OUTCOMES OF HEMIARTHROPLASTY IN HEMODIALYSIS PATIENTS

Ahmet Salduz et al. Acta Ortop Bras. 2017 Sep-Oct.

Abstract
in English, Portuguese

Objective: The aim of this study was to evaluate the functional results, complications, and morbidity and mortality rates in patients with end-stage chronic renal failure (ESCRF) with collum femoris fractures who were treated with hemiarthroplasty.

Methods: From 2005 to 2013, patients with ESCRF admitted to our hospital with collum femoris fracture and treated with hemiarthroplasty were retrospectively evaluated, and 44 hips in 42 patients were included in the study. Duration of hospital stay, bleeding, complications, morbidity and mortality were recorded for each patient. At the last control evaluation, patients were assessed via pelvis x-ray and functional status according to Harris Hip Score (HHS).

Results: Patients required a mean 2.7 units of erythrocyte suspension. Mean hospital stay was 19.74 days. The most common complication was bleeding. The complication rate was 38.1%; mortality rate at first-year follow-up was 42.8%, and mean HHS was 74.5.

Conclusion: Collum femoris fractures are more common in ESCRF patients due to metabolic bone disease, and these patients had many comorbidities which may exacerbate high complication and mortality rates. Orthopedic surgeons should consider these higher complication rates and inform patients about the consequences of this treatment. Level of Evidence IV, Case Series.

Objetivo: O objetivo deste estudo foi avaliar os resultados funcionais, as complicações e as taxas de morbidade e mortalidade em pacientes com insuficiência renal crônica em estágio terminal (IRCT) com fraturas do colo do fêmur tratados com hemiartroplastia.

Métodos: De 2005 a 2013, pacientes com IRCT internados em nosso hospital com fratura do colo do fêmur e tratados com hemiartroplastia foram avaliados retrospectivamente, e 44 quadris em 42 pacientes foram incluídos no estudo. Durante a estadia hospitalar, hemorragia, complicações, morbidade e mortalidade foram registradas para cada paciente. Na última avaliação de controle, os pacientes foram examinados com radiografias da pelve e quanto ao estado funcional, de acordo com o Harris Hip Score (HHS).

Resultados: Os pacientes precisaram em média 2,7 unidades de suspensão de eritrócitos. A estadia hospitalar média foi 19,74 dias. A complicação mais comum foi hemorragia. A taxa de complicações foi 38,1%; a taxa de mortalidade no primeiro ano de acompanhamento foi 42,8% e o HHS médio foi 74,5.

Conclusão: As fraturas de colo do fêmur são mais comuns em pacientes com IRCT, em decorrência da doença óssea metabólica, e esses pacientes apresentam muitas comorbidades que podem exacerbar as altas taxas de complicação e mortalidade. Os cirurgiões ortopédicos precisam considerar esses altos índices de complicações e informar os pacientes sobre as consequências desse tratamento. Nível de Evidência IV, Série de Casos.

Keywords: Femoral neck fractures/complications; Hemiarthroplasty; Hemodialysis; Kidney failure, chronic/complications; Mortality.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. 80-year-old male patient with left collum femoris fracture. (A) Preoperative AP view of pelvis; (B) Postoperative AP view of left hip; (C) AP view of left hip after implant removal due to ongoing periprosthetic infection.
Figure 2
Figure 2. 65-year-old male patient. (A) AP view of pelvis showing left femoral component loosening at 7-year follow-up. (B) AP and lateral views of left hip after revision surgery. (C) AP view of left femur showing periprosthetic femoral fracture; (D) AP view of left femur after osteosynthesis of the fracture.
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