The need of routine histopathological examination of resected head of femur after hemiarthroplasty: An observational study

Author(s): Dr. Manoranjan Mallik, Dr. Ramesh Chandra Maharaj, Dr. Amaresh Prasad Mohapatra, Dr. Debi Prasad Nanda, Dr. Suvam Choudhury and Dr. Amrit Kumar Panda

Abstract: The neck of femur fracture is one of the commonest fracture amongst the elderly. Hemiarthroplasty is sought as the standard of treatment in these group of patients. Following surgery the resected head of femur is discarded. Though it has become a norm for routine histopathological evaluation of the head in total hip replacement but this is not the same in hemiarthroplasty. We studied 48 femoral head obtained after hemiarthroplasty in fracture neck of femur. Majority of our patients were female 28(58.33%) and the mode of injury in them was fall at home 19(67.85%) with mean waiting time for surgery 13±2.7days (Range 7.6-18.4days). We found degenerative osteoarthritis in form of Chondromalacia in 26(54.16%) patients among which males 15(57.69%) were the predominant variety presenting with a higher stage which was statistically significant in nature (P value= 0.014, χ2 value=5.994, df=1). Avascular necrosis was seen in 11(22.91%) cases. Though we found female (6) to be more affected but it was not statistically significant (P value=0.772, χ2 value=0.084, df=1). We found no cases of neoplasm or infection in our study. The histopathological study of the femur head didn’t alter the further treatment plan of the patients. Hence we won’t recommend doing a routine tissue study of the resected head in these group of patients without any prior positive history (like neoplasm) which will lead to savings over health expenses.

DOI: https://doi.org/10.22271/ortho.2020.v6.i4m.2436