RESUMO Objetivo: Traçar o perfil epidemiológico dos pacientes idosos com fratura de fêmur proximal atendidos no Hospital Regional de Cotia - SP, além de descrever o estado nutricional desses pacientes. Método: As informações para confecção deste trabalho foram obtidas a partir dos prontuários eletrônicos dos pacientes atendidos no período agosto de 2020 a abril de 2021. As variáveis estudadas foram: idade, sexo, etnia, peso e altura (para cálculo do índice de massa corporal - IMC) e presença de comorbidades. Também foram avaliadas as circunstâncias da fratura, tais como mecanismo do trauma, localização anatômica e tratamento instituído. Ainda, avaliou-se o perfil nutricional dos pacientes por meio da Mini Avaliação Nutricional (Mini-MAN). Resultados: Predominaram pacientes do sexo feminino, brancas, com média de 80 anos de idade e IMC médio de 23,55 kg/m 2 . Quase todos os pacientes se acidentaram em casa, e as comorbidades mais observadas foram hipertensão arterial sistêmica, diabetes mellitus e doença de Alzheimer. A grande maioria dos pacientes foi considerada desnutrida ou em risco de desnutrição. Conclusão: O estado nutricional dos idosos parece estar diretamente relacionado ao risco de fraturas proximais do fêmur. Nível de Evidência II, Estudo Retrospectivo.

ABSTRACT Objective: To identify the epidemiological profile of older patients with proximal femoral fractures treated at the Hospital Regional de Cotia, SP - Brazil, and describe the nutritional status of these patients. Methods: Data were obtained from the electronic patient medical records from August 2020 to April 2021. The variables studied were age, gender, ethnicity, weight and height (for BMI calculation), and presence of comorbidities. Fracture circumstances were also assessed, including trauma mechanism, anatomical location, and treatment. Moreover, the nutritional profile of patients was assessed using the Mini Nutritional Assessment (MAN). Results: Most patients were white women, with a mean age of 80 years and an average BMI of 23.55 kg/m2. Almost all patients suffered the fracture at home and the most common comorbidities were systemic arterial hypertension, diabetes mellitus, and Alzheimer’s disease. Most patients were considered to be malnourished or at risk of malnutrition. Conclusion: The nutritional status of older adults seems to be directly related to the risk of proximal fractures of the femur. Level of Evidence II, Retrospective Study.

OBJECTIVES: Our primary aim was to compare the long-term survivorship rates and the rates of successful osseointegration between two different types of uncemented acetabular components. INTRODUCTION: Two types of alloys have primarily been used for the manufacture of the uncemented acetabular components: titanium-based and cobalt-based alloys. A titanium-based alloy appears to be more effective with regard to interface stress transfer to the host bone because of its lower elastic modulus relative to a cobalt-based alloy. This supposed mechanical advantage of a titanium-based alloy component motivated this comparative study. METHODS: Two uncemented acetabular components, a porous-coated acetabulum and a Plasmacup®, were compared with a focus on long-term prosthesis survivorship and the development of acetabular osseointegration. Five radiographic signs of osseointegration were evaluated at the last follow-up appointment: (1) absence of radiolucent lines, (2) presence of a superolateral buttress, (3) medial stress-shielding, (4) radial trabeculae, and (5) an inferomedial buttress. We considered the presence of any three of these radiographic signs, in the absence of acetabular dislocation or symptoms, to be indicative of successful acetabular osseointegration. RESULTS: Among 70 patients implanted with the porous-coated acetabulum, 80% achieved osseointegration over a mean follow-up time of 11.9 years versus 75.3% of the 73 patients who received a Plasmacup insert over a mean of 10.7 years. Prosthesis survivorship rates were not different between the two groups. Revision surgery due to mild or severe acetabular osteolysis, polyethylene wear, and aseptic loosening occurred in eight patients (11.4%) with a PCA versus nine (12.3%) with a Plasmacup. CONCLUSIONS: We conclude that, during the first ten years after surgery, there is no significant difference between these two types of uncemented cups with regard to either prosthesis survivorship or successful osseointegration.