Body response to primary joint replacement after proximal femur injuries in patients with an increased body mass index (preliminary study)

Han H.Z., Akhtiamov I.F., Garifullov G.G., Faizrakhmanova G.M., Kuznetsova R.G.

Abstract


Introduction
Injuries of the proximal femur remains a significant problem of management in the elderly persons. The traditional approach comprising osteosynthesis of bone fragments is a method of choice in standard situations but showed to be insufficient in patients with an increased body mass index (BMI). Significant delay in full weight-bearing walking ability in this group of patients after fixation with dynamic systems needs to be solved with a nonstandard approach to their treatment. Therefore, arthroplasty after fractures of the proximal femur allows us to hope for an improved walking already in the early stages of rehabilitation in such a difficult group of patients.
Methods
Early results of hip replacement in 52 patients with fractures of the proximal femur were analyzed. They were divided into two groups: group I with obesity (28 cases, BMI ≥ 25) and group II with a normal body weight (24 cases, BMI less 25). Intraoperative and postoperative hemoglobin and blood loss counts, duration of the operation, frequency of early complications and the Harris hip score at six and 12 months after surgery were compared.
Results
Statistical analysis of the parameters showed a significant relationship between overweight, duration of the operation and blood loss, as well as clinical and functional treatment outcomes at six months after joint replacement measured with HHS scale (p less 0.05). Significant efficiency of arthroplasty was revealed in the rehabilitation period.
Conclusion
Obesity complicates hip arthroplasty but significantly affects the body response of patients with injuries in the hip area only in the early stages of treatment.

Keywords


arthroplasty, obesity, fracture, proximal femur

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