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TOTAL HIP ARTHROPLASTY FOR DISPLACED FEMORAL NECK FRACTURES: MATCHED-PAIR ANALYSIS WITH A 3.5 TO10 YEAR FOLLOW UP.

7th Congress of the European Federation of National Associations of Orthopaedics and Traumatology, Lisbon - 4-7 June, 2005



Abstract

Effectiveness of total hip arthroplasty (THA) for acute fracture of the femoral neck is still debated. The purpose of this retrospective controlled study was to compare the results of THA done for fracture of the femoral neck with a similar group of matched THAs done for osteoarthritis (OA).

From 1993 to 2000, 25 patients (25 hips) had THA for displaced femoral neck fracture. There were 18 women and 7 men, with a mean age of 73+/− 8.5 years (range, 55 to 93 years). The control group was composed of 25 patients (27 hips) who had THA for primary OA. Patients were matched for age, sex, medical comorbidity, surgical approach, prosthesis, and surgeon. Cemented implants with a Me-PE couple were used in the great majority. All patients had radiographic assessment. Functional results were rated according to the grading system of Merle d’Aubigné.

One patient (one hip) was lost to follow-up in each group. The mean follow-up was 6 years (range, 3.5 to 10 years). No revision was performed in this series. Complications included one postoperative dislocation in both groups. At the last follow up evaluation, 21 hips and 23 hips were classified excellent or very good in the “fracture” group and in the control group respectively. No progressive radiolucent line and no osteolysis were recorded. Mean annual PE wear was 0.096 +/− 0.094 (range, 0 to 0.26 mm) in the studied group compared with 0.125+/− 0.095 (range, 0 to 0.24 mm) in the control (p=0.30).

THA for acute femoral neck fracture and THA for OA provided comparable mid to long term results in elderly patients.

Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.