Cementless Bipolar Hemiarthroplasty in Hemodialysis Patients with Displaced Femoral Neck Fracture

We retrospectively reviewed 34 cementless bipolar hip hemiarthroplasties performed in 32 hemodialysis patients with femoral neck fractures between 1995 and 2005. The mean age of the patients was 73.3 years (range, 57-81 years). The patients were followed up for a mean of 5.3 years (range, 1-12 years). Ten (31.3%) patients died a mean of 17.4 months after the operation (range, 13 days to 53 months). Two patients died during hospitalization, and a total of five patients died within the first year following the index surgery. Nine medical complications occurred during hospitalization: urinary tract infection (two), congestive heart failure (two), ischemic heart attack (two), pulmonary embolism (two), and pneumonia (one). There were five deep infections and four periprosthetic fractures. Ten additional surgeries were performed in eight patients: resection of the prosthesis (four), open reduction with internal fixation (three), debridement (one), delayed reimplantation of the total hip arthroplasty after resection (one), and total hip revision because of central protrusion of the prosthesis (one). Sixteen patients (17 hips) were available at the latest follow-up time (26-112 months; mean, 71 months). Their Harris hip scores averaged 68.4 points (range, 26-91 points). The radiological study found three loosening stems, and two other hips were considered to have central protrusion of the bipolar cup. Our study highlights the high mortality and complication rates in hemodialysis patients treated with a cementless bipolar prosthesis for femoral neck fracture.

並列關鍵字

bipolar hemiarthroplasty ； femoral neck fracture ； hemodialysis

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