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January 1, 2021National Journal of Clinical Orthopaedics0 citationsOpen Access

Hip arthroplasty as a salvage procedure for failed fixation of hip fractures

HRHarish Narayan Singh RajpurohitAJAbhishek JaroliHBHiren Bhalala

Key Result

Salvage hip arthroplasty significantly improved the mean Harris Hip Score from 32.95 preoperatively to 77.80 at final follow-up (p < 0.001) in patients with failed fixation of proximal hip fractures.

Study Design

Type

Observational (n=20)

Multicenter

No

Structured PICO

Does hip arthroplasty improve functional outcomes in patients with failed internal fixation of hip fractures?

P
Population
20 adult patients (mean age 59.9 years, 50% female) with failed internal fixation of proximal hip fractures who underwent salvage hip arthroplasty, followed for up to 20 months.
I
Intervention
Hip arthroplasty (Total hip replacement in 13 patients, bipolar hemiarthroplasty in 7 patients)
O
Outcome
Functional outcome assessed by Harris Hip Score (HSS)patient reported

Hip arthroplasty serves as an effective salvage procedure that significantly improves functional outcomes in patients with failed internal fixation of hip fractures.

Main Result

Absolute Event Rate: 77.8% vs 32.95%

p-value: p=<0.001

Limitations

  • Diversity of implant fixation method in the primary treatment of the fracture
  • Diversity of the prosthetic implant used for revision
  • Small number of patients
  • Limited follow-up

Abstract

Failed surgical treatment of hip fractures presents a significant challenges in elderly osteoporotic population typically leads to profound functional disability and pain. Revision internal fixation and a salvage treatment with hip arthroplasty are two accepted treatment options. The purpose of this study was to assess the intra operative difficulties encountered and to evaluate the functional outcome of hip arthroplasty performed after failed internal fixation of intertrochanteric (IT) and fracture neck of femur (NOF). 20 patients with failed internal fixation (June 2012 to October 2013) were enrolled and operated during the study period. Functional assessment was done using the Harris Hip Score (HSS) and complications, if any, were documented. There were 11 cases (55%) with failed IT fracture and 9 cases (45%) of failed fixation of NOF fractures. Total hip replacement (THR) was performed in 13 patients (6 cemented and 7 uncemented) and bipolar hemiarthroplasty was done in 7 patients (4 cemented and 3 uncemented). The mean time interval to failure was 3.31 years (SD ± 3.17). The Harris hip score improved from preoperative 32.95 (SD ± 7.54) to 77.80 (SD ± 9.22) at final follow up which was significant (p < 0.001). Also the mean difference of improvement in preoperative Harris hip score and any postoperative score or between any two successive post-operative Harris hip scores was significant (P value

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Cite This Study

Rajpurohit et al. (2021) conducted an observational in Failed internal fixation of proximal hip fractures (n=20). Salvage hip arthroplasty vs. Preoperative baseline was evaluated on Harris Hip Score (HHS) at final follow-up (p=<0.001). Salvage hip arthroplasty significantly improved the mean Harris Hip Score from 32.95 preoperatively to 77.80 at final follow-up (p < 0.001) in patients with failed fixation of proximal hip fractures.

synapsesocial.com/papers/6a97a3356ccf0d1eee31c9b2https://doi.org/10.33545/orthor.2021.v5.i1b.267
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