Abstract
Background: Fractures of the proximal femur in the elderly patients represent a challenge for the orthopedic surgeons due to osteoporosis and numerous illnesses that can aggravate the morbidity and complicate treatment. Internal fixation and arthroplasty are the two main options for the treatment. The optimal treatment remains controversial. Aim of the work: The present study aimed to evaluate the early clinical and functional outcomes of cementless hip replacement in elderly patients with Fractures of the proximal femur. Patients and methods: From January 2016 to March 2018 a prospective case series study was conducted on 24 participants (26 hips) with 2 year follow up and mean age 67.19 ± 8.38 years (60- 88 years). Twenty three cases (88 %) had fracture neck femur and three cases (12 %) had intertrochanteric fracture. Twenty cases (77 %) underwent cementless THA and six cases (23 %) had cementless bipolar hip arthroplasty. Modified lateral approach was used in all patients. Main criteria for clinical assessments were Harris hip score (HHS) and The Quality of Life Scale (QOLS). Results: HHS was used for clinical evaluation of patients, prefracture and postoperatively at 6 weeks, 6 months, 1 year and 2 years. The mean postoperative HHS for all patients in the last follow up (2 years) was 86.93 ± 11.62 (range, 71- 98). On the other hand, The QOLS was used for evaluation of patient’s satisfaction. The meanpostoperative QOLS at 2 year was 86.06 ± 11.13 (range, 55- 97) with no statistically significant difference between pre-fracture and postoperative. Conclusion: The results of this study suggest that cementless hemiarthroplasty and cementless THA offers good treatment option for displaced proximal femoral fractures in the elderly with overall good functional outcomes. It gives very satisfactory results that are comparable to published data. Longer follow up is needed toelaborate stronger clinical evidence. Level of evidence: (IV) a prospective case series trial.
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