J Korean Orthop Assoc.  2014 Dec;49(6):454-462. 10.4055/jkoa.2014.49.6.454.

Early Results after Treatment of Femoral Neck Fractures with Total Hip Arthroplasty Using Cementless Fiber Metal Taper(R) Stem in Elderly Patients

• Shin WC
• Lee SM
• Woo SH
• Suh KT

• KMID: 2185159
• DOI: http://doi.org/10.4055/jkoa.2014.49.6.454

Abstract

PURPOSE
The purpose of this study was to evaluate the early results of clinicoradiological outcomes after cementless total hip arthroplasty (THA) for displaced femoral neck fracture in elderly patients.
MATERIALS AND METHODS
A total of 44 cementless THA procedures performed between January 2008 and January 2012 for displaced femoral neck fracture in patients older than 65 years of age were enrolled in this study and all patients presented normal cognitive ability preoperatively and were followed for more than two years after surgery. We evaluate the clinical and radiological results. The mean age was 72 years (range 65-81 years), 34 patients were female, and 10 patients were male. The mean follow-up period was 30.7 months.
RESULTS
Clinically, at the last follow-up, the mean Harris hip score was 96.5 points. Walking ability was recovered postoperatively in 79.5% of cases (35 cases), and activities of daily living were achieved in 66% of cases (29 cases). Radiographically, none of the acetabular cups showed evidence of migration, loosening, or osteolysis. All cases showed excellent or good fixation postoperatively and stable bony fixation of the femoral stem, with the exception of one case, who presented with a periprosthetic fracture during follow-up. There were no cases of osteolysis, significant alignment change or progressive subsidence. Postoperative dislocation occurred in two cases (4.5%), but no re-dislocations were observed after closed reduction.
CONCLUSION
Short-term outcomes proved to be satisfactory in elderly patients older than 65 years of age, who presented with normal cognitive ability preoperatively, undergoing cementless THA for displaced femoral neck fractures.

Keyword

femoral neck; femoral neck fracture; cementless total hip arthroplasty

MeSH Terms

Acetabulum
Activities of Daily Living
Aged*
Arthroplasty, Replacement, Hip*
Dislocations
Female
Femoral Neck Fractures*
Femur Neck
Follow-Up Studies
Hip
Humans
Male
Osteolysis
Periprosthetic Fractures
Walking

Figure

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  Figure 1 (A) Preoperative radiograph of an 80-year-old female shows a displaced femoral neck fracture. (B) Postoperative radiograph shows excellent implant position of cementless total hip arthroplasty. (C) Postoperative radiograph at 28 months shows stable fixation of components without subsidence or changes in alignment.

• 

  Figure 2 (A) Preoperative radiograph of a 77-year-old male shows a displaced femoral neck fracture. (B) Immediate postoperative radiograph shows additional circlage wiring for an intraoperative liner femoral fracture. (C) Postoperative radiograph at 24 months shows stable fixation of the cementless femoral stem after circlage wiring.

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