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IS THE AUSTIN MOORE HEMI-ARTHROPLASTY AN EFFECTIVE TREATMENT MODALITY FOR DISPLACED SUB-CAPITAL FEMORAL FRACTURES IN PATIENTS OVER 75 YEARS OLD?



Abstract

All patients who had received an Austin Moore hemi-arthroplasty between 6 February 1998 and 14 July 2002 were included in the study. Of the 101 patients, 34 were lost to follow-up, 34 had passed away and one did not give consent for the study. The Physical Performance of Activities of Daily Living (PODL) was evaluated, using a modified version of the functional status index by Jette. The level of social functioning was determined by a questionnaire developed by House . Muscular function was evaluated by a timed ‘carpet run’ of 20 m and measuring the time it took to rise twice from an armless chair. The data were compared to an age-matched control group of 44 volunteers.

The 45% complication rate in the study group included four dislocations (12%), two femoral fractures (6%) and three deep infections (9%). The social functioning questionnaire showed an average or above average score in most of the patients, 22 of whom (69%) were satisfied with the results. On the PODL score 19 patients (60%) were above average in dependency. Ten (31%) reported no functional pain and four (10%) reported severe pain. Muscular function tests showed a statistically significant difference between the operated group and the control group, with the mean ‘carpet run’ three times longer.

Even though the study showed good results as far as dependency and social functioning was concerned, there was a high complication rate and a low objective functional outcome. We concluded it was an effective procedure for patients who did not have high functional expectations, and that physiological status should play a greater role than chronological age in therapeutic decision-making.

The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.