Total Hip Arthroplasty for Femur Neck Fractures in Elderly Patients. A Multi-Centre Study from Pakistan

Introduction: The burden of hip fractures on health care systems and professionals is increasing with increase in life expectancy of patients. There is an increasing global trend for total hip replacement rather than Hemiarthroplasty for femur neck fractures in elderly patients. This is based on large series reported from various countries showing efficacy, safety and better functional outcome associated with this procedure. The concerns with Total hip replacement procedure include increased risk of dislocation, infection and anaesthetic complications. The adoption of this practice in developing countries pose additional challenges including access to medical facility, availability of equipped operating room, financial burden and the surgical expertise required for Total Hip Replacement for this unique group of patients.

Objectives: To evaluate the effectiveness and associated complications of total hip arthroplasty for femur neck fractures in elderly patients from various centres in Pakistan.

Materials and Methods: Retrospective cohort of patients from 3 different hospitals in the country was included. Data was obtained from prospectively held databases and patients with at least 12 months follow up were included in the study.

Results: A total of 63 patients were included in the study, including 27 males and 36 females with an average age of approximately 62 years. The commonest implant type used was cemented hip replacement with commonest head size being 32 mm. Only two patients had superficial wound infection, 1 patient had pulmonary embolism and 1 patient had dislocation at 2 months. No mortalities were reported during the study period.

Conclusion: THA is a safe option for carefully selected patients with neck of femur fractures. In a developing country, despite numerous constraints we are still able to reproduce the same results as published in the international literatur