Hip Pelvis.  2014 Dec;26(4):256-262. 10.5371/hp.2014.26.4.256.

The Early Result of Cementless Arthroplasty for Femur Neck Fracture in Elderly Patients with Severe Osteoporosis

• Seo JS
• Shin SK
• Jun SH
• Cho CH
• Lim BH

• KMID: 1907702
• DOI: http://doi.org/10.5371/hp.2014.26.4.256

Abstract

PURPOSE
The purposes of the current study were to assess the early results of cementless hip arthroplasty (HA) for femoral neck fractures in elderly patients with severe osteoporosis and to compare the clinical outcomes between those who underwent total HA (THA) or bipolar hemiarthroplasty (BHA).
MATERIALS AND METHODS
From April 2011 to May 2012, we performed 87 cementless HAs for displaced femoral neck fractures in elderly patients (> or =65 years) with severe osteoporosis. Among them, we studied 70 hips that were able to be followed-up for >24 months. Of these, 34 underwent THA and 36 underwent BHA. Clinical results were evaluated using the Harris hip score (HHS), Koval classification, and radiographs.
RESULTS
Only one instance of femoral stem loosening was observed. Additionally, no dislocations were observed and no revision surgeries were required. The mean changes in the functional items of the HHS scores were 2.8 and 5.2 for those who underwent THA and BHA, respectively (P<0.05). According to the Koval classification used for the ambulatory status analysis, the mean perioperative change in the grade was 0.8 (0-4), with no significant differences noted between the THA and BHA groups.
CONCLUSION
The early results of cementless HA for femur neck fractures in elderly patients with osteoporosis were satisfactory, and THA was found to have a functional advantage over BHA.

Keyword

Elderly; Osteoporosis; Femur neck fractures; Cementless arthroplasty

MeSH Terms

Aged*
Arthroplasty*
Butylated Hydroxyanisole
Classification
Dislocations
Femoral Neck Fractures*
Hemiarthroplasty
Hip
Humans
Osteoporosis*
Butylated Hydroxyanisole

Figure

• 

  Fig. 1 (A) An 87-year-old woman (T-score, -4.6) with a displaced femoral neck fracture who had undergone a bipolar hemiarthroplasty using a cementless implant. (B) On anteroposterior radiographs obtained 2 years postoperatively, the implant is well fixed with a stable bone ingrowth.

• 

  Fig. 2 (A) A 74-year-old woman with a displaced femoral neck fracture who had undergone a bipolar hemiarthroplasty using a cementless stem. An intraoperative femoral crack was treated using Dall-Miles cable. (B) On anteroposterior radiographs obtained 2 years postoperatively, the stem is well fixed.

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