Total hip arthroplasty with minimal invasive surgery in elderly patients with neck of femur fractures: our institutional experience

Injury ◽  
2015 ◽  
Vol 46 ◽  
pp. S13-S17 ◽  
Author(s):  
Jean-Christophe Bel ◽  
Jean-Paul Carret
10.29007/zddn ◽  
2019 ◽  
Author(s):  
Thomas Apostolou ◽  
Ioanna Chatziprodromidou

Minimal invasive surgery has gained popularity among hip surgeons and patients. Based on early studies, the method is described as a very promising alternative, with low dislocation rates, resulting in a non-traumatic procedure and early functional return. However, complication rates arising of the recent studies raise concern about the applied technique. The aim of the study is to present the clinical results and intra- and post-operative complications of the AMIS procedure in patients with osteoarthritis of the hip, managed with total hip arthroplasty with positioning table, in a 5 years follow up. One senior hip arthroplasty surgeon performed all surgeries. Three hundred eighteen consecutive patients (195 females, 123 males) were clinically and radiologically evaluated, postoperatively 2, 6 and 12 months. Mean patient age was 69.7 years (24 to 88). There was significant improvement according to Harris-Hip Score, ODI, SF-36 scales. The mean incision length was 7.5cm (6 to 8cm). The mean operating time was calculated at 85 minutes. The patients were discharged on the second post-operative day, able to walk with partial weight bearing. One month post-operative, the patients were advised for full weight bearing walking without crutches. Intraoperative complications included two femoral perforations. Postoperative complications included two patients with femoral fractures; one with dislocation; two with superficial infections; three with wound complications; three with femoral stem aseptic loosening; one with ceramic inner fracture and two acetabular component protrusion in the same patient, among which only the last patient had reoperation in both hips. Anterior Minimal Invasive Surgery of the hip is a non-traumatic procedure, associated with reduced pain, faster recovery and no major complications, but requires higher experience level from the hip surgeon.


Injury Extra ◽  
2012 ◽  
Vol 43 (10) ◽  
pp. 105
Author(s):  
Z. Gamie ◽  
J. Neale ◽  
D. Shields ◽  
J. Claydon ◽  
S. Hazarika ◽  
...  

2020 ◽  
Vol 27 (1) ◽  
pp. 68-71
Author(s):  
Jatinder Singh Luthra ◽  
Suwailim Al Ghannami ◽  
Salim Al Habsi ◽  
Soubhik Ghosh

Internal fixation is commonly used to treat fractures in the hip. However, failure of proximal femoral fracture fixation is common and treated with total hip replacement (THR). The aim of this study is to present our midterm results of dual mobility (DM) THR for failed internal fixation of proximal femur fractures. Between 2010 and 2015, a total of 28 cases of failed internal fixation for hip fractures were treated through DM total hip arthroplasty. Two patients died during the early postoperative period due to medical complications. The average follow-up was 3.4 years. We had one patient with superficial surgical site infection which was managed by local wound debridement and dressings. The average Harris hip score was 85. DM THR is the procedure of choice for revising failed internal fixation for hip fractures in our patients with good clinical outcome.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
W Khan ◽  
A Baig ◽  
Q Afzaal ◽  
J Davison ◽  
S Hutchings ◽  
...  

Abstract Aim To identify the mortality associated with failed internal fixation and hemiarthroplasty of neck of femur fractures. Method Patients undergoing conversion of internal fixation / hemi arthroplasty were identified from theatre records and surgical databases. Data was stored in Microsoft Excel spreadsheet. Clinical outcomes at 30 days, 1 year and 5 years post conversion total hip replacement. Results 60 cases were collected between June 2006 and November 2016. 46 females and 14 males involved in the case. The mean age of male patients was 66.5 and for females 67.9. 32 patients had previous sliding hip screw fixation,12 had intra-medullary nails, 8 had cannulated screw fixation and 5 patients had hemiarthroplasty. The mean time to failure was 22 months (Range: 2 weeks to 60 months) and there were 6 cases of late posttraumatic arthritis (range 4 yrs to 23 yrs). Average time from documented failure to conversion THR was 2 months. There were 2 superficial wound infections which were successfully treated with antibiotics. There were 2 cases of deep infection which required multiple debridement, washout, and prolonged inpatient stay. Average duration of hospital stay was 5.7days. 18 patients died before 5 years for reasons unrelated to their hip. All had a functional prosthesis at time of last review. 42 patients alive at 5 years had a functional prosthesis at last review Conclusions Total Hip Arthroplasty is a successful procedure for failed fixation / hemiarthroplasty despite the technical challenges. A 3–5-year mortality rate of 33.33 % reflects well against the NHFD 1year mortality of 30 %.


2020 ◽  
Vol 102-B (6) ◽  
pp. 693-698 ◽  
Author(s):  
Aparna Viswanath ◽  
Anum Malik ◽  
Warwick Chan ◽  
Antonio Klasan ◽  
Neil P. Walton

Aims Despite few good-quality studies on the subject, total hip arthroplasty (THA) is increasingly being performed for displaced intracapsular fractures of the neck of femur. We compared outcomes of all patients with displacement of these fractures treated surgically over a ten-year period in one institution. Methods A total of 2,721 patients with intracapsular fractures of the femoral neck treated with either a cemented hemiarthroplasty or a THA at a single centre were retrospectively reviewed. The primary outcomes analyzed were readmission for any reason and revision surgery. We secondarily looked at mortality rates. Results We found no difference in the overall revision rate or rate of infection. However, the rates of readmission due to dislocation, pain, and trochanteric bursitis were significantly higher in the THA group (p = 0.001, p < 0.001, p < 0.001, and p = 0.001, respectively). Conclusion Our study, comparing the outcomes of neck of femur fractures treated with a cemented hemiarthroplasty and THA, revealed the perceived superiority of THA was not borne out by our results. This should be carefully considered before any radical change in practice regarding the use of THA for displaced intracapsular fractures of the femoral neck. Cite this article: Bone Joint J 2020;102-B(6):693–698.


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