Effectiveness Of Total Hip Arthroplasty In The Treatment Of Displaced Femoral Neck Fractures In The Elderly

Objective: To summarize the effectiveness of total hip arthroplasty(THA)in the treatment of displaced femoral neck fractures in the elderly.Methods: A retrospective review was made on 51 old patients who had THA due to displaced femoral neck fractures between January 2005 and February 2016.There were 16 males and 35 females with a mean age of 72 years(range,65~85 years).All the prostheses were fixed biologically.The diameter of prosthetic femoral head was 36 mm in 16 hips and was 28 mm in 35 hips;Operation time,intraoperative blood loss and postoperative complications were evaluated.The Harris hip score(HHS)was used to evaluate the hip joint function,The visual analogue scale(VAS)score was used to evaluate postoperative thigh pain.Radiographic evaluation was used to evaluate periprosthetic osteolysis,prosthesis loosening and so on.Results: Healing of incision by first intention was achieved in all patients after operation.There was no complication of anesthetic accident,or neurovascular injury.The mean operation time was 81 min(range,50~108min).The mean of the intraoperative blood loss was 503 ml(range,200~1000 ml).No severe general complications occurred after operation.All patients were followed up for 1-8 years(mean,5 years).At the final follow-up,no dislocation of the hip occurred,the mean Harris hip score was 88 points(range,75~100 points).2 patients(4%)reported mild thigh pain.The postoperative X-ray images showed that all acetabular cups were placed at the anatomical position,and the initial femoral stem prosthesis fixation was rated as excellent or good,and that fixation of the femoral component was classified as stable with bone ingrowth in all hips.At the final follow-up,the X-ray images showed that all the acetabular components and femoral stems were well fixed,with no osteolysis or prosthesis loosening observed.Two hips were found to have heterotopic ossification of Brooker grade I.No patients need revision at the final follow-up.Conclusion: Total hip arthroplasty can provide excellent clinical results in the treatment of displaced femoral neck fractures in the elderly.