Total Hip Arthroplasty for Hip Fractures

Abstract

Introduction: This study aimed to determine the dislocation and reoperation rate, functional outcomes, and the survival rate of the unique subset of very old but lucid and independent patients with hip fractures following a total hip arthroplasty (THA) and geriatric team-coordinated perioperative care. Method: Between 2000 and 2006, previously independent ambulatory patients 80 years old presenting with an intracapsular hip fracture were given THAs under the care of an integrated orthopedic surgerygeriatric service. Their fracture-related complications, ambulation, mental status, and survival were followed for 5 to 11 years postinjury. Results: Five years postinjury, 57 (61.3%) patients of the original study group were living. In all, 3 (3.2%) patients had postoperative hip dislocations (and 2 patients had dislocation twice) and 2 reoperations were needed within the first postoperative month. There were no hip dislocations or reoperations after the first year. Radiographs obtained on 88% of the surviving patients at 5 years postoperatively showed that all remained unchanged from their immediate postoperative images. Nearly half of the patients were still able to ambulate as they did preoperatively and their mixed-model equation was statistically unchanged. Conclusion: This study of patients >80 years old with previously good functional status demonstrates that with appropriate surgical (best prosthesis, good operating technique, and regional anesthesia) and geriatric (pre-and postoperative assessments, close follow-up, medication adjustments, and fall-prevention instruction) care, they have few hip dislocations and reoperations, survive postfracture at least as long as their noninjured contemporaries, and continue to function and ambulate as they did prior to their injury.

Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility

“…Although none of the patients in this study suffered falls during the monitoring, the related literature highlights the need to establish evaluation and fall prevention programs after arthroplasty surgeries. This policy becomes imperative due to the risks presented by patients undergoing THA, who mostly have functional limitations and advanced age ( 19 ) . In the study sample, the NOC scores showed that the patients presented from moderate to frequent fall prevention behavior, demonstrated throughout the evaluations.…”

Different Stabilization Techniques for Type 62B3 Acetabular Fractures in Combination With Primary Total Hip Arthroplasty in Elderly Patients

“…The recently published 5-year follow-up of functional outcomes in the oldest independent old and very old patients (>80 years old) with previously good functional status has demonstrated that with appropriate surgical and geriatric care, they have few hip dislocations and reoperations, survive postfracture at least as long as their noninjured contemporaries, and continue to function and ambulate as they did prior to their injury. 17 It is noteworthy that when the fracture fixation is followed by acute THA, the perfect reduction of fracture is not required. The resected femoral head may be used for the autograft of bone defects.…”

Intraoperative Periprosthetic Fractures in Total Hip Arthroplasty in Patients With Sickle Cell Disease at King Fahad Hospital Hofuf: A Cross-Sectional Study

“…Total hip arthroplasty (THA) is a saving procedure used to relieve pain and functional disability associated with many hip problems, most commonly, primary hip osteoarthritis, posttraumatic arthritis, and avascular necrosis in sickle cell disease patients [1][2][3][4][5][6]. Sickle cell disease is endemic in Saudi Arabia due to the high percentage (57.7%) of consanguineous marriages, rising to more than 80% in some rural areas [7,8].…”

“…One of the main complications of THA for sickle cell disease (SCD) patients is periprosthetic hip fracture [1][2][3][4][5][6]. The incidence of fracture is affected by gender, age, race, BMI, implant fixation type, proximal femoral morphology, sickle cell genotype, and hemoglobin (Hb) level [7][8][9][10][11][12].…”

“…A systemic review and meta-analysis undertaken in 2014 [14] revealed a high incidence of periprosthetic fractures after THA in females older than 80 years. Some studies have found that the incidence of periprosthetic fracture is higher in whites with low BMIs [1][2][3][4][5]. Proximal femoral morphology can be radiologically classified before reconstruction according to the Dorr classification [15,16].…”