Complications and Midterm Outcomes of Hemiarthroplasty in Hemodialysis Patients

Abstract

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.

Surgical Challenge in the Management of Spontaneous, Bilateral, Nontraumatic, Neglected Femoral Neck Fractures in a Patient With End-Stage Renal Disease: A Case Report and Literature Review

“…This was due to coagulopathy associated with renal failure and the use of low-molecular-weight heparin as prophylactic post-surgery. MI, PE, infections not responding to debridement alone and necessitating removal of the implant, pneumonia, urinary tract infection, and sepsis were other complications associated with hemiarthroplasty in end-stage renal disease patients [ 10 , 19 ]. Stem migration in cemented hemiarthroplasty was reported in most cases in the first three years post-surgery in patients with renal failure.…”

Pathological fracture of subtrochanter femur, soft tissue infection along the fracture site, shaft femur bone cortex thickening and blastic lession on contralateral shaft femur due to renal osteodystrophy on the end stage renal disease patient: a case report

“…Occurrence of a fracture is the result of a fall in addition to failure in mechanical strength. [3][4][5] The infection can be multifactorial in origin. In this case, the infection can be occurred because of dysregulation of the immune system in the CKD patient and higher susceptibility to infection with increasing in age.…”

Fracture Cascade in Patients with End-Stage Renal Disease: Complications and Outcome

“…However, the compromised bone quality frequently leads to failed osteosynthesis, and that is why the sentiment of many authors is gradually shifting in favour of arthroplasty in comparison to internal fixation [8]. Nevertheless, the overall complications of arthroplasty are definitely much higher, and long-term results are guarded, which is leading to the reality that there is still no gold standard in treating non-displaced femoral neck in ESRD [9]. …”