| ABSTRACT: |
Between 1973 and 1983, 27 patients with acute
femoral neck fractures were treated at the UCLA Medical Center with total
hip arthroplasty. These cases were selected on the basis of age, high activity
level, and degenerative changes in the acetabular cartilage. The average
age was 72 years. There were 19 women and eight men. The average follow-up
period was 3.8 years with a range of one to ten years. Methods used included
analysis of clinical data, roentgenograms, final pain ratings, walking ratings,
and activity levels using the UCLA rating system. Pain relief and overall
functional results were better than that of most series of acute femoral
neck fractures treated with hemiarthroplasty and similar to that of total
hip arthroplasty series. The complication rate was slightly less than both
authors' elective total hip series, and considerably less than most hemiarthroplasty
series. Complications included a superficial wound infection, a urinary
tract infection, and a perforated colon diverticulum. Four patients died
within one year from causes unrelated to the hip arthroplasty. There were
no deep infections, dislocations, or reoperations. Total hip arthroplasty
in selective cases of acute femoral neck fractures can give more consistent
pain relief and better functional results than hemiarthroplasty, without
an increase in complications. |