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Τρίτη 15 Ιανουαρίου 2019

Cementless Total Hip Arthroplasty Following Failed Internal Fixation for Femoral Neck and Intertrochanteric Fractures: A Comparative Study with 3-13 Years’ Follow-up of 96 Consecutive Patients

Publication date: Available online 14 January 2019

Source: Injury

Author(s): Nam Hoon Moon, Won Chul Shin, Jung Shin Kim, Seung Hun Woo, Seung Min Son, Kuen Tak Suh

Abstract
Background

The aim of this study was to investigate the postoperative outcomes of cementless Total hip arthroplasty (THA) following failed internal fixation for femoral neck and intertrochanteric fractures.

Method

Ninety-six cementless THAs for failed internal fixation after femoral neck fracture (59, group I) and intertrochanteric fracture (37, group II) with a minimum follow-up of 3 years were analyzed. Clinical and radiologic evaluations were performed on all patients.

Results

The intraoperative blood loss and operating time were significantly increased in group II (p = 0.001, p = 0.001, respectively). Harris hip score at last follow-up was significantly improved in group I (p = 0.007) but, there were no differences in hospital stay, Koval score at last follow-up, and perioperative complications between both groups. Long femoral stems for diaphyseal fitting were frequently used in group II (32/37, 86%) (p = 0.001). Radiographically, none of the acetabular cups showed evidence of migration, loosening. All cases showed stable fixation of the femoral stem at last follow-up.

Conclusions

Outcomes of cementless THA following failed internal fixation for femoral neck and intertrochanteric fractures were satisfactory; increased intraoperative blood loss, operating time, and requirement of long femoral stem should be considered in the latter type of fracture.



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