Won Chul Shin; Sang Min Lee; Seung Hun Woo; Kuen Tak Suh

doi:10.4055/jkoa.2014.49.6.454

Journal List > J Korean Orthop Assoc > v.49(6) > 1013337

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Shin, Lee, Woo, and Suh: Early Results after Treatment of Femoral Neck Fractures with Total Hip Arthroplasty Using Cementless Fiber Metal Taper® Stem in Elderly Patients

Original Article

Journal of the Korean Orthopaedic Association 2014; 49(6): 454-462.

Published online: 30 December 2014

DOI: https://doi.org/10.4055/jkoa.2014.49.6.454

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

Won Chul Shin, M.D., Sang Min Lee, M.D., Seung Hun Woo, M.D., Kuen Tak Suh, M.D., Ph.D.

Department of Orthopedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Correspondence to: Kuen Tak Suh, M.D., Ph.D. Department of Orthopedic Surgery, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 626-770, Korea. TEL: +82-55-360-2125, FAX: +82-55-360-2155, kuentak@pusan.ac.kr

Received 24 June 2014 Revised 22 July 2014 Accepted 7 August 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: femoral neck, femoral neck fracture, cementless total hip arthroplasty

Figures and Tables

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.

Table 1

Demographic Data of Patients

Values are presented as number only or median (range). BMD, bone mineral density; ASA, American society of Anesthesiologists.

Table 2

Recovery of Walking Ability and Activities of Daily Living

Values are presented as number (%) or number only.

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