Clinical Outcome after Hemiarthroplasty among Patients with Fracture Neck of Femur in South Indian Population

Abstract

Background: Femoral neck fractures in the elderly are serious injuries, often occurring in the terminal years of life and they have a major impact on society, our healthcare system, and the cost of care. It has a high incidence rate and complications. A successful surgery at the hip joint should provide a painless and stable hip. Hemiarthroplasty is the common method of treating displaced femoral neck fractures in Garden’s type III and IV in the elderly. This study aims to evaluate the clinical outcome and quality of life following hemiarthroplasty. Materials and methods: It is a retrospective study including a total of 101 patients who underwent hemiarthroplasty (cemented/uncemented) using unipolar or bipolar prosthesis due to femoral neck fracture at the Institute of Orthopaedics and Traumatology, Coimbatore Medical College Hospital, Coimbatore, during the period of 2 years between 2017 and 2019. In this analytical retrospective study, we studied several variables including age, sex, socioeconomic status, medical comorbidities, clinical outcome, postoperative complications, quality of life, frequency of follow-up, and mortality. Results: In our study, most of the patients were in the age-group of 60–70 years with a mean age of 65 years. This study was carried out on 43 males and 58 females. There was no intraoperative complication/mortality. A total of 21 patients had complications. These were (a) posterior dislocation (3), (b) aseptic loosening (1), (c) periprosthetic fracture (1), (d) superficial infection (11), (e) deep infection (1), and other minor complications like persistent hip pain and muscle wasting. The mortality rate was about 23.7% at 1-year follow-up. Conclusion: The overall complications following hemiarthroplasty were acceptable. The immediate complications rate was about 8.9% and the late complication rate was about 17.8%. Targeted medical intervention that focuses upon susceptible patient groups may reduce morbidity, mortality, and improve survival.