Efficacy of hip replacement in the treatment of intertrochanteric femoral fractures in older adult patients and its effect on human β-defensin 3 and N-arachidonoylethanolamine levels
10.3760/cma.j.cn341190-20240813-01036
- VernacularTitle:髋关节置换治疗老年人股骨粗隆间骨折的效果以及对HBd-3、AEA水平的影响
- Author:
Lei WANG
1
;
Wujun YUAN
;
Jiamin HE
;
Bin LIU
Author Information
1. 西安工会医院骨科,西安 710100
- Publication Type:Journal Article
- Keywords:
Femoral fractures;
Arthroplasty,replacement,hip;
Fracture fixation,intramedullary;
beta-defensins;
Oxidative stress;
Postoperative complications;
Chemokines
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(9):1349-1354
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of hip replacement on human β-defensin 3 (HBd-3) and N-arachidonoylethanolamine (AEA) levels in older adult patients with intertrochanteric femoral fractures.Methods:This study was a retrospective analysis. A total of 110 older adult patients with intertrochanteric femoral fractures who received treatment at Xi'an Labor Union Hospital from March 2021 to December 2023. Based on the different treatment methods, patients were assigned to either the hip replacement group ( n = 55, hip replacement) or the control group ( n = 55, intramedullary nail fixation). The operation time, postoperative bed rest duration, hospital stay, and weight-bearing time were recorded for both groups. The levels of malondialdehyde, aldosterone, tumor necrosis factor-alpha, HBd-3, AEA, and calcitonin gene-related peptide were measured before and 3 days after surgery. Behaviors were evaluated using the 6-point behavioral rating scale before and 14 days after surgery. Hip function was evaluated using the Mayo hip function score before and 3 months after surgery. Complications were recorded for both groups. Results:The operation time in the hip replacement group was significantly longer than that in the control group [(75.58 ± 7.19) minutes vs. (60.03 ± 5.75) minutes, t = -12.53, P < 0.001]. However, postoperative bed rest duration, hospital stay, and weight-bearing time in the hip replacement group were (8.35 ± 1.63) days, (13.18 ± 2.32) days, and (6.19 ± 1.51) days, respectively, which were significantly shorter than those in the control group [(16.28 ± 2.02) days, (15.65 ± 3.15) days, (42.21 ± 6.67) days, t = 22.68, 4.68, 39.06, all P < 0.001]. The levels of malondialdehyde and aldosterone in the hip replacement group were (14.89 ± 3.06) U/L and (37.80 ± 3.80) ng/L, respectively, which were significantly lower than those in the control group [(16.73 ± 3.42) U/L, (40.85 ± 4.24) ng/L, t = 2.97, 3.97, both P < 0.05]. Additionally, the levels of tumor necrosis factor-α and HBd-3 in the hip replacement group were (18.85 ± 3.25) ng/L and (0.93 ± 0.15), respectively, which were significantly lower than those in the control group [(24.40 ± 4.43) ng/L, (1.22 ± 0.30), t = 7.49, 6.41, both P < 0.001]. The level of calcitonin gene-related peptide in the hip replacement group was significantly lower than that in the control group [(73.81 ± 12.26) ng/L vs. (89.39 ± 14.43) ng/L, t = 6.40, P < 0.001]. The level of anandamide in the hip replacement group was significantly higher than that in the control group [(112.65 ± 18.35) ng/L vs. (95.28 ± 14.07) ng/L, t = -5.57, P < 0.001]. The 6-point behavioral rating scale score in the hip replacement group was significantly lower than that in the control group [(1.05 ± 0.32) vs. (2.28 ± 0.67), t = 12.29, P < 0.05]. The Mayo hip function score for patients in the hip replacement group was significantly higher than that in the control group [(85.12 ± 4.33) vs. (79.38 ± 4.12), t = 7.12, P < 0.001]. The incidence of complications in the hip replacement group was significantly lower than that in the control group [1.82% (1/55) vs. 14.55% (8/55), χ2 = 4.36, P < 0.05]. Conclusions:Hip replacement therapy for older adult patients with intertrochanteric femoral fractures can shorten hospital stays, promote the reduction of postoperative stress responses and inflammation, downregulate HBd-3 and AEA levels, facilitate early functional rehabilitation, improve hip function, reduce complications, and enhance prognosis.
