Primary total hip arthroplasty versus hemiarthroplasty for displaced neck femur fractures in older patients

Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity and mortality, and loss of independence. Objectives: To determine whether total hip arthroplasty is associated with lower reoperation rates, mortality, and complications, and better function and quality of life than hemiarthroplasty for displaced fractures of the femoral neck in older patients. Materials and methods: We prospectively as well as retrospectively studied 46 patients treated with total hip replacement or hemiarthroplasty. Pain, range of motion, hip function, haris hip score and complications were assessed clinically while hip stability, femoral anteversion, acetabular cup inclination and acetabular erosions were assessed radiographically. Results: In our study according to Harris hip score, group A (hemiarthroplasty group) showed 58.33% excellent to good result whereas 33.34% shows fair to poor result. In group B (total hip replacement group) 90.91% showed excellent to good result and 9.08% showed fair to poor result. In this study, the overall Harris hip score was 76.33 with SD±19.091 in hemiarthroplasty group and 86.45 with SD±6.363 in Total hip replacement group with p-value 0.0224(<0.05). Nitin Kumar Singh, Himanshu Jain, Sonal Garg, Sachin Yadav. Primary total hip arthroplasty versus hemiarthroplasty for displaced neck femur fractures in older patients. IAIM, 2017; 4(10): 209-215. Page 210 Conclusion: So we concluded in our one year of study that total hip replacement had better functional outcome in fracture neck of femur in elderly treated by either hemiarthroplasty or total hip replacement and total hip replacement is less painful than hemiarthroplasty.

Role of vertebroplasty in osteoporotic compression fracture

xMajority of osteoporotic vertebral compression fracture present with back pain and some of them with spinal deformity. Percutaneous vertebroplasty not only addresses pain relief but also the correction of spinal deformity with least post-operative morbidity. 72 patients with osteoporotic compression fracture and spinal deformity with chronic invalidating pain treated with percutaneous vertebroplasty were followed for 2.8 years with an average of 1.3 years.47% showed excellent,13% showed good and 40% showed fair result on vas score. There was good improvement in stature in 43%, fair in 40% and 17% showed no improvement.