The Total Hip Replacement Arthroplasty for Femur Neck Fractures in the Elderly

Jae Hwan Cho; Chang Hyun Ryu; Kye Young Han

doi:10.5371/hp.2013.25.3.197

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Cho, Ryu, and Han: The Total Hip Replacement Arthroplasty for Femur Neck Fractures in the Elderly

Original Article

Hip & Pelvis 2013; 25(3): 197-202.

Published online: 30 September 2013

DOI: https://doi.org/10.5371/hp.2013.25.3.197

The Total Hip Replacement Arthroplasty for Femur Neck Fractures in the Elderly

Jae Hwan Cho, MD, Chang Hyun Ryu, MD, Kye Young Han, MD, PhD

Department of Orthopaedic Surgery, Kangwon National University College of Medicine, Chuncheon, Korea.

Address reprint request to Kye Young Han, MD, PhD. Department of Orthopaedic Surgery, Kangwon National University Hospital, 17-1 Hyoja 3-dong, Chuncheon 200-722, Korea. TEL: +82-33-258-9256, FAX: +82-33-244-2205, hkyljh@kangwon.ac.kr

Received 10 June 2013 Revised 29 August 2013 Accepted 3 September 2013

(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

To analyze the clinical and radiological outcomes of total hip replacement arthroplasty (THRA) for the treatment of femur neck fractures in the elderly.

Materials and Methods

Femur neck fracture patients older than70 years of age, who showed good preoperative walking ability without dementia,and underwent THRA between February, 2008 and March, 2010 were reviewed retrospectively. Twelve patients(13 hips) were enrolled and the mean ages of the patients were 79.4(70-91). The mean follow-up period was 31(20-49) months. The modified Koval index was used to determine the clinical outcome. Inclination and anteversion of acetabular cup, loosening, osteolysis, periprosthetic fractures and dislocations were evaluated using the radiographs.

Results

The modified Koval index decreased from 4.92 to 4.84 at the final follow-up, but the decrease was not significant (P=0.339). Dislocations occurred in 2 cases postoperatively(2/13, 15.4%). No other complications were encountered.

Conclusion

The THRA for the treatment of femur neck fractures in elderly patients over 70 years of age showed satisfactory clinical and radiological outcomes. Nevertheless, caution should be taken regarding the relatively high incidence of postoperative dislocations.

Keywords: Femur neck, Fractures, Old age, Total hip replacement arthroplasty

Figures and Tables

Fig. 1

Porous coating acetabular cup and minimal collar polished stem were used in these series (Implantcast, Buxtehude, Germany).

Fig. 2

Seventy-eight female patient was admitted for right femur neck fracture (A) Preoperative radiograph showed Garden type IV femur neck fracture. (B, C) Total hip replacement arthroplasty was done. (D, E) Posterior dislocation occurred at postoperative 3 weeks.

Table 1

Modified Koval Index

Table 2

The Demographic Data and Clinical and Radiological Outcomes of All Patients

N: case number, M: male, F: female, Lat.: laterality, R: right, L: left, F/U: follow-up.

^†This patient underwent Rt. THRA followed by Lt. THRA for consecutive femur neck fractures. The follow-up period was calculated from the first operation.

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