Hemiprosthesis for Femoral Neck Fractures in the Elderly: A Retrospective Study of 319 Patients

Abstract

BackgroundIn geriatric patients with Pauwels types II and III femoral neck fractures, hemiprosthesis is the therapy of choice.ObjectivesThis study was conducted to analyze the results after cemented hemiprosthesis placement, the first year after surgery.Patients and MethodsThis retrospective study was conducted on 319 patients over 70 years with displaced femoral neck fractures treated surgically at our hospital from 2007 to 2012. All medical information was available including retrospective posthospital discharge records as well as inpatient course and one-year mortality.ResultsFrom a total of 319 patients, 78% (n = 249) were female and 22% (n = 70) were male, with the mean age of 83.6 years. Seventeen percent of the patients suffered from heart failure, 23% from diabetes, and 19% from renal insufficiency. Time to surgery averaged one day postinjury. Average operative time skin-to-skin was 50 minutes. Seventy-three percent of the patients could mobilize independently on discharge. Of the remaining patients, 2/3 had already lost independent mobilization prior to the fracture. Hospital mortality averaged 5% (national average in Germany: 8%), and 30-day and 90-day mortality rates were 5% and 15%, respectively. Within one year, 22% of the patients died (national average: 27%). Also, 14 patients were re-admitted, for contralateral prosthetic implantation (n = 7) or revision after the periprosthetic fracture (n = 5). Fifty-three percent of the patients were admitted to hospital during the year for other diseases (national average: 54%).ConclusionsHemiprosthesis placement for displaced femoral neck fractures is a common and safe procedure. Despite recent decreases in hospital mortality, the risk of death remains more than twice as high within one year than that for uninjured patients of the same age.

Femoral Stem Subsidence and its Associated Factors after Cementless Bipolar Hemiarthroplasty in Geriatric Patients

“…Hip hemiarthroplasty is one of the most common surgery performed for femoral neck fracture other than total hip arthroplasty. Compared to total hip arthroplasty, the procedure is relatively faster, with less bleeding and earlier weight-bearing mobilisation 5 . There are no significant differences between the advanteges of cementless and cemented stem, however a comparison study reported that there are more respiratory or cardiovascular complications and longer duration of surgery in cemented stem 6 .…”

A larger sized cup accelerates cartilage erosion of acetabulum after bipolar hemiarthroplasty in elderly with femur neck fracture

“…In such patients, the BHA is considered a reasonable option to regain good function [3] . It is preferred as it requires less operative time, less blood loss, technically easier procedure than THA [4] . It also has a relatively lesser dislocation rate compared to THA [5,6] …”

“…[ 3 ] It is preferred as it requires less operative time, less blood loss, technically easier procedure than THA. [ 4 ] It also has a relatively lesser dislocation rate compared to THA. [ 5 , 6 ]…”

A Larger Sized Cup Accelerates Cartilage Erosion of Acetabulum after Bipolar Hemiarthroplasty in Elderly with Femur Neck Fracture

“…In such patients, bipolar hemiarthroplasty(BHA) is considered a reasonable option to regain good function 3 . It is preferred as it requires less operative time, less blood loss, technically easier procedure than total hip arthroplasty 4 . It also has a relatively lesser dislocation rate compared to total hip arthroplasty 5,6 .…”