Hip Arthroplasty in Patients with End-Stage Renal Disease on Dialysis

Patients with chronic renal failure under regular hemodialysis usually encounter hip problems as osteonecrosis, fracture, and osteoarthritis due to renal osteodystrophy, amyloid arthropathy and steroid use. In such cases, hip arthroplasty surgeries are usually performed. However, several studies have addressed dismal clinical results for patients undergoing hip arthroplasty while on chronic dialysis. Presently, we retrospectively analyzed 64 hip arthroplasties in 56 chronic dialysis patients over a 12 year period to clarify the relationships between clinical results and causes of surgery. Fifty-six patients (average age 64.3 years at surgery) received total 64 hip arthroplasties including 22 total hip arthroplasty (THA), 29 bipolar hemiarthroplasty and 5 Austin-Moore hemiarthroplasty due to the diagnosis of ischemic necrosis of femoral head in 17 patients, displaced femoral neck fracture in 32, cutting out of dynamic hip screw or pinning screws in six and advanced osteoarthritis in one. Mortality rate in the hemiarthroplasty group is apparently higher than THA group (55.9% vs. 9%) and more associated with surgery (23.5% vs. 0%). The reasons may include the more advanced age in the hemiarthroplasty group (72.7 vs. 51.4) and more complex comorbidities. We are encouraged by the comparable results in the THA group and believe it remains a durable and reliable procedure in the chronic dialysis patients after complete preoperative evaluation. Concerning hemiarthroplasty in femoral neck fracture, more attention should be paid for the perioperative cares and medical managements.

並列關鍵字

total hip arthroplasty ； ESRD ； dialysis ； renal transplantation ； bipolar hemiarthroplasty ； Austin-Moore hemiarthroplasty

國際替代計量

全文下載

主題瀏覽