A RANDOMISED CONTROLLED TRIAL- COMPARING CEMENTED MODULAR BIPOLAR HEMIARTHROPLASTY WITH CEMENTED TOTAL HIP REPLACEMENT IN FRACTURES OF FEMORAL NECK IN ELDERLY PATIENTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 79
Abstract
BACKGROUND Femoral neck fractures have remained as ‘unsolved fractures’ till today due to the high rate of associated complications. In the Indian scenario, the focus is always on femoral head preservation. In the elderly, however, the options in managing femoral neck fractures seem to be more in favour of head sacrificing surgery such as arthroplasty and the procedure may vary from either cemented to uncemented fixation or hemiarthroplasty to total joint replacement. Nevertheless, the ‘gold standard’ and the most appropriate treatment for these fractures remain controversial. The purpose of this study was to analyse the outcome of displaced femoral neck fractures in elderly patients who were fit to receive either a hemiarthroplasty using cemented modular (bimodular/bimod) bipolar prosthesis or total hip arthroplasty using a cemented prosthesis in terms of operation time, blood loss and transfusion, duration and cost of hospitalisation, hip joint function, pain relief, post-operative complications, rate of dislocation, revision and mortality. MATERIALS AND METHODS Over a period of 3 years (2013 - 2016), a prospective randomised controlled trial study was carried out for a total of 40 cases of acute fracture of neck of femur in elderly patients, aged more than 65 yrs. attending the OPD and Emergency Department of Orthopaedics, Gauhati Medical College and Hospital. The patients were followed up and were evaluated clinically, radiologically and functionally (using Harris Hip Score). RESULTS In the HRA group, we achieved excellent functional results in 70% cases and in the THA group we achieved excellent functional results in 90% cases and there was no statistically significant difference in terms of Harris Hip Score in both the groups. CONCLUSION From our study, we have seen that there is no significant difference in treatment of neck of femur fractures treated with THA and HRA in terms of functional results and intra- and post-operative complication. However, there is a significant difference in intraoperative blood loss between the two types of procedures.
Authors and Affiliations
Tulasidas Bhattacharyya, Tridip Bharali, Kishore Hazarika, Rajarshi Roy, Sidhartha Baruah, Bikash Agarwal, Hrishikesh Bharali, Kiran Sonowal
Keywords
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- EP ID EP268149
- DOI 10.14260/jemds/2017/1217
- Views 50
- Downloads 0
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