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
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