title: Large diameter metal on metal total hip replacement for femoral neck fractures with neurological conditions: A retrospective assessment.
abstract: BACKGROUND
  Patients with Parkinson's disease and poliomyelitis can have a femoral neck fracture; yet, the optimal methods of treatment for these hips remains controversial. Many constrained or semi-constrained prostheses, using constrained liners (CLs) with a locking mechanism to capture the femoral head, were used to treat femoral neck fractures in patients with neurological disorders. We retrospectively studied a group of patients with Parkinson's disease and poliomyelitis who sustained femoral neck fractures and were treated by total hip arthroplasty using an L-MoM prosthesis.
  
  
  METHODS
  We retrospectively reviewed 12 hips in 12 patients who underwent large-diameter metal-on-metal (L-MoM) total hip replacement between May 2007 and October 2009. Eight of the 12 patients (8 hips; 66.7%) had Parkinson's disease and 4 patients (4 hips; 33.3%) were affected with poliomyelitis.
  
  
  RESULTS
  The followup time was 5.2 years (range 3.6-6.0 years). At the latest followup, all the patients showed satisfactory clinical and radiographic results, with pain relief. No complications, such as dislocation or aseptic loosening occurred.
  
  
  CONCLUSIONS
  We believe the use of L-MoM can diminish the rate of instability or dislocation, after operation. The L-MoM is an option for patients with Parkinson's disease and poliomyelitis with femoral neck fracture.
authors.affiliation: Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.affiliation: Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Jinzhu
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Denghui
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Xu
keywords: Femoral neck; Femoral neck fracture; Parkinson's disease; hip replacement; metal on metal prosthesis; poliomyelitis; total hip arthroplasty