Noncemented Cathcart elliptical head endoprosthesis for displaced femoral neck fractures.
A total of 93 patients (95 hips) undergoing unipolar noncemented elliptical head endoprosthetic replacement for an acute displaced femoral neck fracture were reviewed clinically and radiographically at an average follow-up of 28 months. The 12-month mortality rate was 22%. The medical complication rate was 15%, and the surgical complication rate was 19%. At most recent follow-up, 66% of patients used an assist device for ambulation or were nonambulatory. Of patients, 64% required full-time nursing care. Radiographically, subsidence of the component was identified in 66% of the hips and acetabular erosion in 29%. More than half of these patients had complaints of either thigh or groin pain. Hips with evidence of subsidence had a statistically significant greater length of follow-up (36 months) compared with hips that did not show subsidence (18 months; P = .014). Noncemented unipolar replacement for displaced femoral neck fractures is an accepted form of treatment. In this group of predominantly male patients, noncemented elliptical head unipolar replacement was associated with a high medical and surgical complication rate as well as poor clinical and radiographic results.
Hartford
J M
JM
Division of Orthopaedic Surgery, Department of Surgery, University of Kentucky Chandler Medical Center, Lexington, Kentucky, USA.
Lauffenburger
M D
MD
Kaufer
H
H
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008124:Locomotion; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D011859:Radiography; D016896:Treatment Outcome