Total hip arthroplasty for acute femoral neck fractures using a cementless tapered femoral stem.
The purpose of this study was to evaluate the osseointegration potential and implant-related complications of cementless total hip arthroplasty with a titanium alloy collarless, tapered, wedge-shaped femoral stem with a proximal circumferential plasma-spray coating in patients with acute hip fractures. The cohort consists of 85 patients with a mean age of 78.1 years. The mean duration of follow-up was 3.8 years. Total hip arthroplasty conferred significant improvement in function for all patients. All femoral components were stable with evidence of bone ingrowth (84 hips) or fibrous fixation (1 hip). Mild thigh pain was present in 3 patients. The complications included dislocation (3 cases), intraoperative femoral fracture (2 cases), and periprosthetic femoral fracture in the postoperative period (1 case). There was one reoperation for revision of the femoral component in the patient with a periprosthetic fracture. There were 25 (29%) deaths. Cementless total hip arthroplasty using a tapered proximally coated femoral stem is a viable option for the treatment of a displaced hip fracture and preexistent arthritis.
Klein
Gregg R
GR
Department of Orthopaedic Surgery, Thomas Jefferson University and the Rothman Institute, Philadelphia, Pennsylvania, USA.
Parvizi
Javad
J
Vegari
David N
DN
Rothman
Richard H
RH
Purtill
James J
JJ
D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000150:complications; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D005265:Femoral Neck Fractures / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D011474:Prosthesis Design; D012086:Reoperation; D016138:Walking