HEMIARTHROPLASTY IN THE ELDERLY FOR FEMORAL NECK FRACTURES: IS THERE STILL ROOM FOR UNCEMENTED STEM? A RETROSPECTIVE STUDY

F. Polidoro¹ , F. Raggini² , G. Guerra¹ , P. Colombo³, V. Salini⁴, A. Belluati⁵

¹ Department of Orthopedics and Traumatology, Santa Maria delle Croci Hospital, Ravenna, Italy
² Department of Orthopedics and Traumatology, University Vita-Salute San Raffaele, Milan, Italy
³ Department of Orthopedics and Traumatology, University Vita-Salute San Raffaele
⁴ Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy
⁵ Orthopaedic and Trauma Department, Hospital Santa Maria delle Croci, Ravenna, Italy

Correspondence to:

Journal of Orthopedics 2022 May-Aug; 14(2): 51-56
https://doi.org/10.69149/orthopedics/2022v14iss2_2

Received: 28 May 2022 Accepted: 8 July 2022

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Abstract

Femoral neck fractures (FNF) are among the most common fractures in the elderly. Choosing the appropriate treatment is essential to achieve the best outcomes and reduce associated mortality. Despite several guidelines suggesting that cemented stem fixation in hemiarthroplasty for medial FNF is highly effective, the use of uncemented hemiarthroplasty (UCHA) still plays an important role. Material and Methods: From January 2013 to May 2018, we conducted a monocentric study that collected data on elderly patients with FNF treated with UCHA. Patients were followed up clinically and via X-rays at 1, 3, 6, and 12 months. The group was analyzed for complications, operative time, blood loss, loosening, and prosthesis survival. Results: A total of 638 patients (654 hips) were identified, with a median follow-up period of 25 months. Over time, 270 patients (41.3%) died. The mean age was 84.9 ± 5.41 years. Four patients (0.5%) experienced intraoperative periprosthetic fractures, and 13 patients (2%) underwent a second surgery. Ten patients (1.5%) showed calcar resorption on X-ray. The mean surgical time was 55 minutes, with an average blood loss of 245 cc. No perioperative deaths were recorded (within 0-2 days postoperatively). The implant survival rate was 98.2% at 1 year, 97.7% at 3 years, and 96.7% at 5 years. Conclusion: UCHA remains an excellent alternative, particularly for patients where reducing surgical time and blood loss is crucial while considering their comorbidities.

Keywords: blood loss, cemented, femoral neck fractures, femur, hemiarthroplasty, hip, operative time, partial total hip, prosthesis, uncemented