Intraoperative periarticular injection can alleviate the inflammatory response and enhance joint function recovery after hip arthroplasty in elderly patients with osteoporotic femoral neck fractures

Shuai Cao; Lingling Zhou; Xu Zhang; Qi Liu; Jinxi Hu; Fang Liu; Yongwei Li

doi:10.1097/md.0000000000024596

February 19, 2021MedicineOpen Access

Intraoperative periarticular injection can alleviate the inflammatory response and enhance joint function recovery after hip arthroplasty in elderly patients with osteoporotic femoral neck fractures

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Why the study?

The study aimed to investigate the potential beneficial effects of multimodal drug periarticular injection on postoperative inflammatory response and joint function after hip arthroplasty in elderly patients with osteoporotic femoral neck fractures.

Does intraoperative periarticular injection of multimodal drugs improve inflammatory response and joint function in elderly patients undergoing hip arthroplasty for osteoporotic femoral neck fractures?

Structured PICO

Does intraoperative periarticular injection of multimodal drugs improve inflammatory response and joint function in elderly patients undergoing hip arthroplasty for osteoporotic femoral neck fractures?

P

Population

56 elderly patients with unilateral osteoporotic femoral neck fractures undergoing hip arthroplasty

I

Intervention

Periarticular injection (PAI) of multimodal drugs intraoperatively before incision closure

C

Comparator

Injection of saline at the same time as placebo

O

Outcome

Inflammatory response (CRP, IL-1β, IL-6, ESR) and joint function (VAS score with activity, Harris hip score) at 1, 2, 4, 7, 14 days and 1, 3 months post-operationsurrogate

Intraoperative periarticular injection of multimodal drugs reduces postoperative inflammation and improves joint function recovery in elderly patients undergoing hip arthroplasty.

Implication

Supports PAI to reduce inflammation and improve function after hip arthroplasty in elderly fracture patients; confirms multimodal injection benefits in this population.

Abstract

PURPOSE: This study aimed to investigate the potential beneficial effects of periarticular injection (PAI) of multimodal drugs on the inflammatory response and joint function after hip arthroplasty in elderly patients with osteoporotic femoral neck fractures. METHODS: Fifty six elderly patients with unilateral osteoporotic femoral neck fractures were randomly allocated to 2 groups: the PAI group, which received the multimodal drug PAI intraoperatively before incision closure, and the control group, which received an injection of saline at the same time as placebo. The C-reactive protein (CRP), interleukin-1β (IL-1β), and IL-6 levels as well as the erythrocyte sedimentation rate (ESR) in peripheral venous blood samples were measured, along with the Visual Analogue Scale (VAS) score with activity and Harris hip score preoperation at 1, 2, 4, 7, and 14 days as well as 1 and 3 months post-operation. RESULTS: The 2 groups were comparable in sex and age, and no significant differences were observed in the preoperative CRP, IL-1β, and IL-6 levels, ESR, VAS score, or Harris hip score between the 2 groups (all P > .05). However, during the postoperative period, the PAI group exhibited significantly lower levels of CRP, IL-1β, and IL-6 as well as a lower ERS and VAS score compared with the control group (P < .05), while the Harris hip score was significantly higher postoperatively in the PAI group (P < .05). CONCLUSION: Multimodal drug PAI can alleviate the inflammatory response and enhance hip function recovery after hip arthroplasty in elderly patients with osteoporotic femoral neck fractures.