Title: Functional Outcome of Total Hip Replacement vs Hemiarthroplasty in Fracture Neck of Femur: A Prospective Study
Authors: Dr Sudesh Sharma, Dr Sonali Sharma, Dr Konika Razdan, Dr Shashi S Sudan
DOI: https://dx.doi.org/10.18535/jmscr/v6i12.105
Abstract
Fracture neck of femur remains an unsolved problem worldwide. There is no single uniformly accepted treatment for all types of fractures for all age groups. The annual incidence of fracture’s as per US annual report is 201 and 197 in men and 511 and 553 in women per 100 000 population. With the improvement in living standards and health care facilities world over, the life expectancy is going high and so is the economic burden of geriatric fractures For old age patients of fracture neck of femur, there is more or less consensus that it should be treated by prosthetic replacement of the head but controversy remains on the issue, whether one opts for a hemiarthroplasty or a total hip arthroplasty, each procedure has its proponents. Hence, this prospective study to compare results of two procedures was undertaken in Govt. Medical College Jammu from January 2014 to December 2017. Study included 90 patients of displaced fracture neck femur in more than 60 years age, divided in two groups A and B. Each group had 45 patients, group A patients underwent a total hip replacement and group B hemiarthroplasty. Patients were followed up for average 26.5 months in group A and 25.6 months in group B. The final functional results were evaluated as per HARRIS HIP SCORE. The average pain score of Group A was 40.2 and Group B 39.1, the average functional score of Group A was 38.0 as compared to 34.0 of Group B. Average range of motion was good in both groups in 82 and 71 percent of patients. The average HARRIS HIP SCORE was 89.4 in Group A and 84.4 in Group B, a significant point in favor of Total hip replacement, although rate of general complications ,dislocations, blood loss, OT time was higher in Group A. We concluded that THR is a better choice than hemiarthroplasty but should be done in patients with longer life expectancy, good socioeconomic strata, active pre-injury status and high demand patients.
Keywords: Total Hip arthroplasty-Hemiarthroplasty-Fracture neck of Femur-Harris hip score.
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