Total hip replacement after hip fracture: primary or secondary surgery? a comparison of clinical and radiological results

ABSTRACT

To compare clinical and radiological results of primary and secondary total hip replacement [THR] after displaced fracture of the femoral neck. Retrospective review of a cohort of 47 patients. All surgeries were performed by the senior author in Al Razi Hospital, Kuwait between 2002 and 2007. Follow- up assessment was done in Al Razi and in Farwaniya Hospital, Kuwait by all authors. Twenty-nine cases of primary THR compared with 18 cases of secondary THR. Cementless, cemented and hybrid implants were used for total hip replacements. Clinical assessment was done using Merle D' Aubigne hip score and radiological assessment was done using standard criteria of geometry of the implant and its stability. Clinical results were better in the primary THR group but radiological results were equivocal. There was tendency to position the cup horizontally in the secondary surgery group. Cementless, cemented and hybrid implants did equally well in our cohort. Primary THR seems to be a better option in displaced fracture of the femoral neck. Cemented cementless and hybrid hip can be used in these cases