Comparison of functional outcome between cemented and un-cemented hemiarthroplasty among the elderly patients with fracture neck of femur
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2017, Vol 3, Issue 2
Abstract
Background: The most common treatment for a displaced femoral neck fracture in the elderly is hemiprosthesis. In the treatment of displaced femoral neck fractures with hemiarthroplasty in elderly patients the use of bone cement is a controversial topic. A cemented hemiarthroplasty has been used in the majority of cases in most countries, but the non-cemented prosthesis is gaining popularity. Aim: To assess and compare the efficacy of cemented and un-cemented bipolar hemiarthroplasty prosthesis in patients with femoral neck fractures. Materials and methods: A prospective longitudinal study was conducted at Vinayaka Missions KirupanandaVariyar Medical College and Hospital in the department of Orthopaedics for a period of two years. All patients with isolated femoral neck fracture and aged above 60 years were included in the study. A total of 60 patients were included in the study and were randomly divided into two groups. Group A patients received cemented prosthesis and group B patients received un-cemented prosthesis. Patients were discharged after two weeks of post-operative period and were followed up at the end of 6 weeks, 3 months and 1 year. During the follow up period in each visit the patient’s functional and radiological assessment was made. The functional outcome was measured by using modified Harris hip score. Results: The mean duration of surgery was less in un-cemented hemiarthroplasty (75.4 mins) compared to cemented hemiarthroplasty (92.8 mins) and the difference in time was found to be statistically significant. Similarly the intra-operative blood loss was more in cemented group than the un-cemented group and the difference was statistically significant. Majority of the patients who had cemented hemiarthroplasty had their modified Harris hip score in the range of good compared to the patients who had un-cemented hemiarthroplasty, where their score was in the range of fair and the difference was found to be statistically significant. The mean score of the patients who underwent un-cemented hemiarthroplasty was 79.8 and for cemented hemiarthroplasty it was 85.5. In the radiological assessment four patients in the un-cemented hemiarthroplasty group showed a varus deformity. Conclusion: The present study concludes that functional outcome of cemented hemiarthroplasty was better than the un-cemented hemiarthroplasty though the operative time and the blood loss was more among the cemented group it had not led to any major complications.
Authors and Affiliations
Kandasamy Ganeshshankar Kandasamy, Kandasamy Meenakshisundaram, Shankar Radhakrishnan
Keywords
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