Use of Double Bone Graft to Stabilize Prosthesis in Uncemented Partial Hip Replacement in Elderly Patients with Fracture Neck of Femur
Journal Title: Orthopaedic Journal of M. P. Chapter - Year 2016, Vol 22, Issue 2
Abstract
Background: Partial hip replacement (cemented or uncemented) is the frequently done surgery in elderly patients with fracture neck of femur. Problems with cementing techniques are reported like increased infection rate and cardiac problems particularly in elderly patients with compromised cardiopulmonary reserve. Austin Moore prosthesis has its own complication like femoral loosening and frequent revision. Material& Methods: We analysed results of 30 patients of fracture neck femur with Dorr type A and B proximal femoral morphology, treated by uncemented partial hip replacement (20 patients with Austin Moore prosthesis,10 patients with bipolar prosthesis) in elderly age group ( range 60 to 75 years) where double bone graft were used for additional stabilization of the stem of prosthesis in femoral canal which included transverse peg grafts in fenestrations and conical graft over the tip of the stem of prosthesis to centralise the stem. Results: The mean follow up was 9.3 years (range from 2 to 15 years). According to Harris Hip score, final outcome was excellent in 21 hips, good in 7 hips and poor in 2 hips.Prosthesis subsidence was found in uncemented partial hip replacement with mean of 2.5 mm (range from 0 mm to 3.5 mm ) which was well tolerated due to bone plugs formed around the tip and fenestrations of prosthesis except in one patient who had complained of thigh pain which required revision with cemented modular prosthesis subsequently. Groin pain was reported in another one patient due to acetabular erosion which required cemented total hip replacement subsequently. There was no incidence of hip dislocation. Conclusions: Our study shows that in addition to the transverse bar by fenestration grafts, bone block formed around the tip of the stem by conical graft provided strong pillar support and once it is integrated, it prevents excessive subsidence of the prosthesis with excellent result.
Authors and Affiliations
Dr Krishna Kumar Pandey
Keywords
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- EP ID EP273139
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The Orthopaedic Journal of M P Chapter (OJMPC) is official publication of Madhya Pradesh Chapter of Indian Orthopaedic Association (IOA). This journal is academic representation of our esteemed body. Publishing a journal...