Hydroxyapatite coated hip hemiarthroplasty: Morbidity and mortality

Abstract

BackgroundUse of uncemented femoral stems for treating displaced intra capsular hip fractures in elderly is increasing worldwide. The aim of our study is to evaluate morbidity and mortality of treatment with a modular fully hydroxyapatite-coated collared femoral stem. Material and methods259 consecutive patients were included in the study. Patients were followed up for12 months. Outcomes were perioperative mortality, perioperative fractures, 30, 120 and 365-day mortality, revision surgery within 30 days and twelve months, length of stay, discharge destination and mobility. ResultsMean age was 85.4 years. 71.8% were female. 63.3% of patients were ASA grade III and IV. 87.6% of patients were operated within 36 h of attendance to hospital. The mortality rate at 30, 120, and 365 days was 8.2%, 15%, and 18.4% respectively with no peri-operative mortality. 0.8% of the patients sustained a peri-operative fracture below the lesser trochanter. Infection and dislocation were 1.1% and 1.5% respectively. 3.4% of the patient underwent further surgery within thirty days but no further surgery in next twelve months. Mean inpatient acute length of stay was 16.8 days, 41.5% of the patients returned to their own or sheltered accomodation within thirty days. 68% of the patients were mobile outdoors prior to the fracture that dropped to 25% at one year after surgery. DiscussionOur study demonstrates that treatment of displaced intracapsular femoral neck fractures in elderly with a full hydroxyapatite coated collared stem has satisfactory outcomes, no perioperative mortality, low one-year mortality and low revision hence a dependable option.