Minimally Invasive Two-Incision Total Hip Arthroplasty for Treating Acute Displaced Femoral Neck Fractures in Active Elderly Patients

Chang-Ich Hur; Taek-Rim Yoon; Kyung-Soon Park; Sang-Gwon Cho; Ji-Hyeon Yim

doi:10.4055/jkoa.2008.43.5.643

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Hur, Yoon, Park, Cho, and Yim: Minimally Invasive Two-Incision Total Hip Arthroplasty for Treating Acute Displaced Femoral Neck Fractures in Active Elderly Patients

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(5): 643-650.

Published online: 31 October 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.5.643

Minimally Invasive Two-Incision Total Hip Arthroplasty for Treating Acute Displaced Femoral Neck Fractures in Active Elderly Patients

Chang-Ich Hur, M.D., Taek-Rim Yoon, M.D., Kyung-Soon Park, M.D., Sang-Gwon Cho, M.D., Ji-Hyeon Yim, M.D.

Center for Joint Disease, Chonnam National University Hwasun Hospital, Jeonnam, Korea.

Address reprint requests to Taek-Rim Yoon, M.D. Brain Korea 21 Project for Biomedical Human Resources Center, Chonnam National University, Center for Joint Disease, Chonnam National University Hwasun Hospital, 160, Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeonnam 519-809, Korea. Tel: +82.61-379-7676, Fax: +82.61-379-7681, tryoon@chonnam.ac.kr

Abstract

Purpose

The purpose of this study was to evaluate the short term follow-up results of minimally invasive (MI) two-incision total hip arthroplasty (THA) for treating acute displaced femoral neck fractures in active elderly patients.

Materials and Methods

We performed a retrospective review of 39 cases (average age: 72 years old, range: 60 years and above) of elderly patients who underwent MI two-incision THA within 30 days of their injury for treating displaced acute femoral neck fractures. They were followed up for a minimum of 12 months. Clinical evaluation was done by comparing the pre-injury and postoperative daily activities, the Harris Hip score (HSS) and the Western Ontario and McMaster University (WOMAC) score. The radiographs were checked to evaluate for implant alignment and periprosthetic abnormalities. The postoperative complications were analyzed.

Results

The average postoperative HSS was 88.3 and the average WOMAC score was 28.8. All the patients were able to walk without any assistive device. One patient had a HHS of less than 70. There were 2 dislocations but there was no recurrence. Radiographically, there was no case with a limb length discrepancy of more than 5mm. The femoral stems did not reveal any subsidence of more than 5mm. Other complications such as osteolysis, infection, neurologic injury and intraoperative periprosthetic fracture were not noted. Especially, no patient complained of any groin pain, which often occurs after bipolar hemiarthroplasty.

Conclusion

The short term follow-up results were good for MI two-incision THA to treat acute displaced femoral neck fractures in active elderly patients, and these procedures were done by an experienced hip surgeon.

Keywords: Hip joints, Femoral neck fracture, Total hip replacement, Minimally invasive

Figures and Tables

Fig. 1

(A) The radiographs of a 78-year old male show a Garden stage IV fracture of the left femur neck. (B) We performed minimally invasive two-incision THA. (C) The radiographs 1 year 10 months after THA show good bone ingrowth. His HHS was 89 and the ADL scale was 1.

Table 1

Harris Hip Score (HSS) at the Last Follow Up

Table 2

Activities of Daily Living (ADL) Scale

Table 3

Radiologic Evaluation

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