COMPARATIVE STUDY
JOURNAL ARTICLE
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Cementless total hip arthroplasty following failed internal fixation for femoral neck and intertrochanteric fractures: A comparative study with 3-13 years' follow-up of 96 consecutive patients.

Injury 2019 March
BACKGROUND: The aim of this study was to investigate the postoperative outcomes of cementless Total hip arthroplasty (THA) following failed internal fixation for femoral neck and intertrochanteric fractures.

METHOD: Ninety-six cementless THAs for failed internal fixation after femoral neck fracture (59, group I) and intertrochanteric fracture (37, group II) with a minimum follow-up of 3 years were analyzed. Clinical and radiologic evaluations were performed on all patients.

RESULTS: The intraoperative blood loss and operating time were significantly increased in group II (p = 0.001, p = 0.001, respectively). Harris hip score at last follow-up was significantly improved in group I (p = 0.007) but, there were no differences in hospital stay, Koval score at last follow-up, and perioperative complications between both groups. Long femoral stems for diaphyseal fitting were frequently used in group II (32/37, 86%) (p = 0.001). Radiographically, none of the acetabular cups showed evidence of migration, loosening. All cases showed stable fixation of the femoral stem at last follow-up.

CONCLUSIONS: Outcomes of cementless THA following failed internal fixation for femoral neck and intertrochanteric fractures were satisfactory; increased intraoperative blood loss, operating time, and requirement of long femoral stem should be considered in the latter type of fracture.

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