Minimally Invasive Two-Incision Total Hip Arthroplasty for Treating Acute Displaced Femoral Neck Fractures in Active Elderly Patients

Abstract

Purpose: The purpose of this study was to evaluate the short term follow-up results of minimally invasive (MI) two-incision total hip arthroplasty (THA) for treating acute displaced femoral neck fractures in active elderly patients. Materials and Methods: We performed a retrospective review of 39 cases (average age: 72 years old, range: 60 years and above) of elderly patients who underwent MI two-incision THA within 30 days of their injury for treating displaced acute femoral neck fracture s. They were followed up for a minimum of 12 months. Clinical evaluation was done by comparing the pre-injury and postoperative daily activities, the Harris Hip score (HSS) and the Western Ontario and McMaster University (WOMAC) score. The radiographs were checked to evaluate for implant alignment and periprosthetic abnormalities. The postoperative complications were analyzed. Results: The average postoperative HSS was 88.3 and the average WOMAC s core was 28.8. All the patients were able to walk without any assistive device. One patient had a HHS of less than 70. There were 2 dislocations but there was no recurrence. Radiographically, there was no case with a limb length discrepancy of more than 5mm. The femoral stems did not reveal any subsidence of more than 5mm. Other complications such as osteolysis, infection, neurologic injury and intraoperative periprosthetic fracture were not noted. Especially, no patient complained of any groin pain, which often occurs after bipolar hemiarthroplasty. Conclusion: The short term follow-up results were good for MI two-incision THA to treat acute displaced femoral neck fractures in active elderly patients, and these procedures were done by an experienced hip surgeon.