Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2024; 15(4): 337-345
Published online Apr 18, 2024. doi: 10.5312/wjo.v15.i4.337
Effect of inflammatory response on joint function after hip fracture in elderly patients: A clinical study
Jia-Ming Wang, Yu-Tao Pan, Chen-Song Yang, Ming-Chong Liu, Sheng-Chao Ji, Ning Han, Fang Liu, Gui-Xin Sun
Jia-Ming Wang, Yu-Tao Pan, Chen-Song Yang, Ming-Chong Liu, Sheng-Chao Ji, Ning Han, Fang Liu, Gui-Xin Sun, Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200092, China
Co-first authors: Jia-Ming Wang and Yu-Tao Pan.
Co-corresponding authors: Gui-Xin Sun and Fang Liu.
Author contributions: Wang JM and Pan YT carried out the studies and drafted the manuscript; Sun GX and Liu F participated in the design of the study and conceived of the study; Yang CS and Liu MC contributed materials/analysis tools; Ji SC and Ning H performed the statistical analysis. All authors participated in the preparation of the manuscript.
Supported by Leading Talents Training Program of Pudong New Area Health Commission, No. PWR 12020-06; and Shanghai Science and Technology Commission, No. 20Y11901800.
Institutional review board statement: Shanghai East Hospital ethics committee reviewed and approved this research under the approval number: [2022] Research Audit No. 278.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gui-Xin Sun, PhD, Professor, Department of Traumatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, No. 150 Jimo Road, Shanghai 200092, China. sunguixin@tongji.edu.cn
Received: October 18, 2023
Peer-review started: October 18, 2023
First decision: January 17, 2024
Revised: January 27, 2024
Accepted: March 15, 2024
Article in press: March 15, 2024
Published online: April 18, 2024
ARTICLE HIGHLIGHTS
Research background

The incidence of hip fractures and postoperative complications in the elderly is increasing. With the advent of the aging society, addressing this public health problem is becoming a non-negligible issue. At present, while the risk factors of hip function recovery after hip fracture in elderly patients are subjects of recent investigation, their specific impact on populations with hip fractures remains relatively not investigated.

Research motivation

In elderly people with hip fractures, the relationship between various inflammatory markers and joint function remains to be further studied.

Research objectives

This study aims to reveal the potential impact of inflammation on joint function in elderly patients with hip fractures, which may provide new approaches for the treatment and rehabilitation of hip fractures.

Research methods

Of 119 patients with hip fractures who underwent elective surgery at Shanghai East Hospital between January 1, 2021, and December 31, 2022 were included in this retrospective analysis. Participants’ comprehensive clinical data, including: Age, sex, hypertension, diabetes, type of fracture site, surgical approach, time from injury to surgery, visual analogue scale score, and length of hospital stay, were collected and analyzed using statistical software. For the measurement data between groups, the independent samples t-test was employed, and for the count data, the chi-square test was utilised. To ascertain the risk factors influencing the functional limitation of the hip joint following a hip fracture, additional multivariate logistic regression analyses were carried out on the covariates that were statistically significant by one-way logistic analysis, with P < 0.05 being deemed statistically significant.

Research results

In this study involving 119 participants with an average age ≥ 75 years, there were no significant differences in age, sex, hypertensive disease, diabetes, fracture types, surgical approach, injury to surgery time, serum neutrophil count, and lymphocyte count. There were significant differences in interleukin (IL)-6, IL-8, IL-10, C-reactive protein (CRP), and complement C1q (C1q) between the two groups. Notably, we also looked at cytokines and complement, which have received relatively less attention in other hospitals in China, and these findings suggest several inflammation-related risk factors for fair joint function in patients with hip fractures.

Research conclusions

To sum up, CRP, IL-6, IL-8 and C1q in patients with fair hip function after surgery were significantly higher than those in patients with excellent hip function in our study.

Research perspectives

These results suggest that there is a certain correlation between inflammatory factors and the postoperative function of hip fracture, and provide a fresh approach for future research of the relationship between inflammation and joint function.