Hip Hemiarthroplasty in the Treatment of Femoral Neck Fracture:
A Retrospective Analysis of 267 Patients
Guilherme Correia*, Mário Baptista, Paulo Cunha, Pedro Pinho,
Guilherme França, André Costa, Pedro Varanda and Bruno
Department of Orthopaedics and Traumatology, Hospital de Braga, R. das
Comunidades Lusíadas, Sete Fontes - São Victor, Braga, Portugal
*Corresponding Author: Guilherme Correia, Department of Orthopaedics and Traumatology, Hospital de Braga, R. das Comunidades Lusíadas, Sete
Fontes - São Victor, Braga, Portugal.
June 12, 2023; Published: August 17, 2023
Purpose:Hip hemiarthroplasty (HA) is considered the best surgical choice in the treatment of femoral neck fracture (FNF) in elderly and low demanding patients, allowing immediate full weight bearing and decreased reoperation rate. HA instability is a serious complication that can lead to revision surgery and dictate lower survival rates. The aim of this study was to identify clinical risk factors associated with an increased risk of dislocation after cemented HA through posterolateral approach.
Methods: Retrospective study of patients with FNF admitted to our institution between 2014 and 2019, treated with bipolar/unipolar cemented HA using a posterolateral approach. Data collected from hospital database included patient demographics, mortality, complications and requirement for revision.
Results: Overall, 267 patients were submitted to HA (84.6% bipolar), with an average age of 84.5 ± 7.1 years and 72% were female. The median hospital stay was 13 days and 43.1% presented medical complications. The prosthesis related complications rate was 13.8% (11.6% instability, 1.1% periprosthetic fracture and 1.1% implant infection) and revision was required in 8.6%. Previous inability to walk [OR 8.55 (95% CI: 3.27-22.38, p < 0.001)] and male gender [OR 2.51 (95% CI: 1.11-5.65, p = 0.026)] where identified as risk factors for instability. One-year mortality rate was 26.7% and was higher among males (p = 0.012).
Conclusion: The instability incidence of cemented HA using posterolateral approach in this study was 11.6%. Previous inability to walk and male gender were identified as risk factors for dislocation after posterolateral approach and may indicate other surgical approaches or treatments.
Keywords: Femoral Neck Fractures; Hip Hemiarthroplasty Dislocation; Complications; Dislocation; Bipolar Hemiarthroplasty; Unipolar Hemiarthroplasty
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