Published March 23, 2023 | Version v1

STUDY OF FUNCTIONAL OUTCOME OF TOTAL HIP REPLACEMENT VERSUS HEMIARTHROPLASTY IN FRACTURE NECK OF FEMUR

  • 1. Professor and HOD, Department of Orthopaedics, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
  • 2. Assistant Professor, Department of Orthopaedics, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.
  • 3. PG Resident, Department of Orthopaedics, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.

Description

Introduction:Inelderlywithdisplacedfemoral neck fractures(FNFs),choicebetweenhemiarthroplastyandTHRhasalwaysbeenadifficultone,boththetreatmentmodalitieshavingtheirownproponents.Hemiarthroplastyisalesscomplexsurgeryandhasbeenassociatedwithreducedcomplications andlowerinitialcosts while THRontheotherhandhasbeenassociatedwithbetterpostoperativefunction.

MaterialandMethods:Thisstudy wasconductedonpatientswithdisplacedFNFswithagemorethan65years,operatedeitherwithTHRorhemiarthroplastyon40patients(20ineachgroup).SouthernMooreapproachwasusedforexposureofthehipjoint.Thefollowupwasdoneat1,3and6monthsduringwhichfunctionalassessmentwasdoneusingHarrisHipScore(HHP)andassociatedcomplicationswerealsoanalyzed.

Results:ThemeanHHPwashigherinTHRgroupthroughoutthestudyperiodbutitwasnotstatisticallysignificant.ThecomplicationsinhemiarthroplastyGroupwereInfectionin10%,PulmonaryEmbolismin5%ofpatients.ThecomplicationsinTHRGroupwereInfectionin5%,LLDin15%,Dislocationin5%ofpatients.

Conclusion:THRprovestobesuperiorintermsofhigherincreaseinHHP.DislocationratesandLimblengthdiscrepancieswerehigherintheTHRgroupbutcanbepreventedwithadequatemeasureswhilethe other complicationswerecomparableinboththegroups.THRshouldbepreferredmethodofmanagementofdisplacedFNFsinactiveelderlypatientswithacceptableratesofcomplications.

 

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