Abstract: Background: Fracture displacement disrupts the femoral head blood supply and increases risk of osteonecrosis of femoral head, delayed union, nonunion and osteoporosis which risks failure of fracture fixation procedures. Total hip arthroplasty improves functional outcome score and decreases pain. In the present study, we aim to measure the functional outcome, hospital stay and rate of complications such as hypotension, pulmonary embolism, infection associated with uncemented Total hip arthroplasty in neck of femur fracture in patients more than 50 years of age. This study aims to evaluate risks and complications and functional outcome associated with surgery.
Materials and Methods: This prospective observational study was carried out in 20 patients admitted in the Department of Orthopaedics of Government Medical College and Sir Sayajirao General Hospital, Vadodara between March 2017 and October 2018. Patients having fracture neck of femur with age more than 50 years regardless of the etiology and type of fracture were included in the study. All patients were operated using Moore’s posterior approach under spinal anesthesia. Patients were followed up at post-operative period of 2 weeks, 1 month, 2 months, 6 months and 12 months for assessment and consultation. Harris hip score was calculated at 12 months.
Results: Mean age of the study was 72.6 years with a 1.5:1 female to male ratio. Average intra-operative blood loss was 350 ml. Only one of the patients had superficial surgical site infection. Average Harris hip score was 85.7 at final follow-up. None of the patients required support for walking. Majority of patients (16, 80.0%) could walk for long distance (>1.5 km) at final follow-up. No radiological abnormality was noted at final follow-up at 12 months.
Conclusion: Despite the poor quality of bone in elder patients, uncemented total hip arthroplasty did not seem to compromise the stability and osseointegration of these components. Therefore, uncemented total hip arthroplasty is a viable option for patients with neck femur fracture in patients of more than 50 years of age.
