TOTAL HIP-ARTHROPLASTY FOR THE TREATMENT OF AN ACUTE FRACTURE OF THE FEMORAL-NECK - LONG-TERM RESULTS

We reviewed the long-term results of 126 consecutive total hip arthrop lasties performed with cement in eighteen men and 108 women who had an acute fracture of the femoral neck. The patients had a mean age of se venty-five years (range, thirty-nine to eighty-nine years) at the time of the operation and were followed for a minimum of 10.1 years (or un til the patient died or had a revision operation) and a maximum of 20. 4 years. The median duration of follow-up was 8.8 years for all patien ts and 15.7 years for the twenty-two patients who were alive at the en d of the study period. Six hips (5 per cent) were revised because of a septic loosening. Survivorship analysis revealed that the probability of survival of the prosthesis without revision (with 95 per cent confi dence intervals) was 95 per cent (91 to 99 per cent) at five years, 94 per cent (88 to 98 per cent) at ten years, 89 per cent (79 to 97 per cent) at fifteen gears, and 84 per cent (66 to 97 per cent) at twenty years. Of the 118 patients who were alive at the one-year postoperativ e examination, 117 (99 per cent) had no pain or mild pain and eighty-o ne (69 per cent) had regained or had an improvement in the preoperativ e level of function. At the latest follow-up examination, eighty-seven (86 per cent) of the 102 patients who were available still had no pai n or only mild pain. Twenty-six patients (21 per cent) had had periope rative medical complications, and twenty-one patients (17 per cent) ha d had operative complications, including thirteen patients (10 per cen t) who had had a dislocation of the hip. Total hip arthroplasty perfor med in elderly patients for the treatment of an acute fracture of the femoral neck was associated with a higher rate of complications than u sually is reported for hemiarthroplasty in such patients. However, the total hip arthroplasty provided good clinical results and was associa ted with long-term survival of the prosthesis.