RESEARCH ARTICLE


Early Complications Following Cemented Modular Hip Hemiarthroplasty



Niall P.T Sullivan*, Andrew W Hughes, Ruth L Halliday, Abigail L Ward , Tim J.S Chesser
Department of Trauma and Orthopaedics, Southmead Hospital, North Bristol NHS Trust, Southmead Way, Bristol, BS10 5NB, UK


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© Sullivan et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Trauma and Orthopaedics, Southmead Hospital, North Bristol NHS Trust, Southmead Way, Bristol, BS10 5NB, UK; Tel: 07793364370; E-mail: niallsullivan@doctors.org.uk


Abstract

Introduction :

Hemiarthroplasty is the recommended treatment for displaced, intracapsular, femoral neck fractures. This study aimed to evaluate the early complications following insertion of the JRI Furlong cemented hemiarthroplasty, a contemporary, modular, double tapered, polished prosthesis.

Method :

A series of 459 consecutive patients (May 2006 - June 2009) treated with a JRI hemiarthroplasty with a minimum of one-year (1-4years) follow-up were evaluated. Data collected retrospectively from clinical records and hospital databases included patient demographics, mortality, deep infection, dislocation, periprosthetic fracture, and any requirement for revision or complications related to the prosthesis.

Results :

Full data were available for 429 of 459 (93%), partial data for 30 (7%). Average age was 83 years (52-100), 76% were female. One-year mortality was 24%. Intraoperative fractures occurred in 17 patients (3.7%). There were two intraoperative deaths. There were nine early deep wound infections (2%). There were two revisions to total hip replacement (THR), four patients required conversion to THR and one underwent an excision arthroplasty procedure.

Discussion :

Early surgical outcomes for the JRI hemiarthroplasty prosthesis are equivalent or superior to other major hemiarthroplasty prostheses previously reported however, there was a high intraoperative fracture rate of 3.7%. We recommend using a stem one size smaller than the final broach in fragile, osteoporotic bone. No patients re-presented with aseptic loosening or stem failure.

Keywords: Cement, fracture, hip, hemiarthroplasty, modular, orthogeriatric..