Comparison between cemented and un-cemented hemiarthroplasty among the patients with fracture neck of femur
Journal Title: International Journal of Orthopaedics Sciences - Year 2018, Vol 4, Issue 1
Abstract
Background: Hemiarthroplasty has been accepted as the treatment of choice for displaced femoral neck fractures. In the recent years the use of bone cement in hemiarthroplasty had become a controversial topic as few studies had recommended the use of uncemented hemiarthroplasty because of its minimal complications. Aim: To compare and assess the efficacy of cemented and uncemented bipolar hemiarthroplasty prosthesis among patients with femoral neck fractures. Methodology: A prospective comparative study was conducted at our hospital from the department of Orthopaedics for a period of one year. Patients aged more than 18 years of age of any gender with fracture neck of femur were included as study subjects. A total of 60 patients were included as our study subjects. It was divided into two groups of 30 each, one group received the cemented and the other group underwent an uncemented hemiarthroplasty. Patients were followed up on the 6th postoperative week for radiological assessment of the implant position and further advised for complete weight bearing as tolerated. Subsequently patients were followed up at 3rd and 12th month. At each visit patient was assessed for recovery based on harris hip score which includes post operative pain, return to activities of daily living, shortening of limb, range of movements, deformity and gait. Results: The duration of surgery was found to be longer in the cemented group with a mean duration of 82.8 mins and among the un-cemented group it was 63.6 mins. The intra-operative blood loss in 60% of the patients among the cemented group had more than 300 ml whereas among the un-cemented group it was only 13.3% had more than 300 ml of blood loss. The mean Harris hip score at the end of 12 months among the cemented group was 81.6 and among the un-cemented group it was 79.07 and both the groups showed a statistical significant improvement in their scores when compared to the score at 3 months whereas no significant difference observed in the scores between the two groups. Conclusion: Both the cemented and uncemented hemiarthroplasty are equally good options in the treatment of fracture neck of femur among elderly patients with minimal complications among the two methods. More data comparing uncemented and cemented hemiarthroplasty in patients with femoral neck fracture are still needed to substantiate our findings.
Authors and Affiliations
Dr. Lakshman Prasath Govindarajan, Dr. Arun Rajamanickam, Shankar Radha Krishnan
Surgical management of complex fracture dislocation of proximal humerus: A report of two cases
Fracture dislocations of the proximal humerus are extremely rare and have poor functional and radiological outcome regardless of many available surgical interventions. We present two such cases where a post traumatic com...
Radiological assessment of closure time of around elbow secondary ossification centers, in Khartoum hospital, Khartoum north hospital, Omdurman hospital, police hospital, and Umbadda hospital, in Khartoum, Sudan (December 2009-2010)
Background: Elbow joint is characterized by 6 secondary ossification centers; in the capitulum, trochlea, lateral and medial epichondyles, olecranon and head of the radius. They are present on plane elbow radiograph at d...
Comparing results of Endoscopic microdiscectomy and conventional discectomy for lumbar disc disease: A short term study
Introduction: Chronic lumbo-sacral pain is a common and challenging clinical entity in pain management centre. The most commonly involved surgical indication are intractable leg or back pain and significant functional im...
Radiological and clinical evaluation amongst types of tibial tunnel widening and choice of graft fixation implants in ACL reconstruction
Objective: To study incidence of tibial tunnel widening and its functional correlation in patients operated with ACL reconstruction with four fold hamstring tendon autograft. To evaluate radiologically and clinically tun...
Clinical profile of patients with distal humerus intercondylar fractures
Inter-condylar fracture of the distal humerus is uncommon injuries and is difficult and challenging fracture for treatment. Restoration of the articular surface of distal humerus must be nearly perfect and sufficiently r...