Highlights
- •We investigated cementless THA performed following failed internal fixation for femoral neck and intertrochanteric fractures.
- •The strength of this study lies in the high number of THA conversions with relatively long-term follow-up periods.
- •Stable fixation of the implant can be achieved with good functional outcome in a reproducible fashion.
- •Consider increased blood loss, operating time, and requirement of long femoral stem in failed internal fixation for intertrochanteric fracture.
Abstract
Background
The aim of this study was to investigate the postoperative outcomes of cementless
Total hip arthroplasty (THA) following failed internal fixation for femoral neck and
intertrochanteric fractures.
Method
Ninety-six cementless THAs for failed internal fixation after femoral neck fracture
(59, group I) and intertrochanteric fracture (37, group II) with a minimum follow-up
of 3 years were analyzed. Clinical and radiologic evaluations were performed on all
patients.
Results
The intraoperative blood loss and operating time were significantly increased in group
II (p = 0.001, p = 0.001, respectively). Harris hip score at last follow-up was significantly
improved in group I (p = 0.007) but, there were no differences in hospital stay, Koval
score at last follow-up, and perioperative complications between both groups. Long
femoral stems for diaphyseal fitting were frequently used in group II (32/37, 86%)
(p = 0.001). Radiographically, none of the acetabular cups showed evidence of migration,
loosening. All cases showed stable fixation of the femoral stem at last follow-up.
Conclusions
Outcomes of cementless THA following failed internal fixation for femoral neck and
intertrochanteric fractures were satisfactory; increased intraoperative blood loss,
operating time, and requirement of long femoral stem should be considered in the latter
type of fracture.
Keywords
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Article info
Publication history
Published online: January 14, 2019
Accepted:
January 12,
2019
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
