Retrospective analysis of the total hip arthroplasty following obsolete femoral neck fracture.

Abstract

Objective To investigate the prosthesis selection and techniques for total hip arthroplas-ty (THA) in patients suffered obsolete femoral neck fracture. Methods From October 2001 to November 2006, a total of 60 patients underwent THA due to obsolete femoral neck fracture were entered in the study, including 30 males and 30 fcmales with an average age of 57.5 years. According to the initial treatment, the patients were divided into expectant treatment group and internal fixation group. Our research compared the type of femoral components, canal flare index and extent of osteoporosis, calculated the limb discrepancy, head length and the position of rotating center. Mean follow-up was 18.4 months. Results 1) 61% and 27% cemented components were utilized in preservation group and internal fixation group, respectively. Further-more, the mean flare and Barnett indices were 2.62±0.85, 3.23±0.68 and 0.40±0.15, 0.48±0.08, respectively. 2) The osteoporosis grade, which the involved side outweighed the healthy appeared in 53% patients. There were 20, 9 and 10 cases characterized by radiolucencies in zone of Delee 1, 2 and 3, respectively. 3) The pre- and postoperative limb discrepancies were (21.8±13.0) mm and (1.5±6.7) mm, respectively. The mean head length was (5.4±2.2) mm. Conclusion Compared to expectant treatment, patients received internal fixation will preserve better bone quality for THA. We should pay more attention to the following points: over reaming responsible for upper shifting of the acetabular component is more common in obsolete femoral neck fracture patients due to osteoporosis. Although the proximal femur moves upward for soft tissue contracture, excessive release will necessitate the lengthened femoral head. Key words: Femoral neck fractures; Arthroplasty, replacement, hip; Osteoporosis