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Short-term results of hip endoprosthesis with hemiprosthesis after femoral neck fracture, maintaining joint lubrication in adult patients

Nikolay Kolarov, Ruslan Popstefanov

Abstract

INTRODUCTION: Femoral neck fracture is one of the most common traumas in adult patients. Usually, the patients with such fractures present with many accompanying diseases, i. e. polymorbidity. The majority of intraarticular femoral neck fractures are indicated for primary hip joint alloplastic surgery. Despite the higher operational risk compared to osteosynthesis, this procedure is preferred for the treatment of femoral neck fractures in patients over 75 years of age.

The main aim of this study is to build-up optimal indications or guidelines for primary endoprosthesis with hemiprosthesis after femoral neck fractures and to justify the choice of an optimal hip hemiprosthetic implant.

MATERIALS AND METHODS: An one-year study assessed the therapeutic effectiveness of the elliptical monoarticular endoprosthetic head use compared to monoarticular spherical and biarticular spherical endoprosthetic head applications based on three groups of criteria: subjective, radiographic, and functional in 167 patients with hemiarthroplasty.

RESULTS: According to the criteria mentioned above, better therapeutic outcomes have been achieved with the use of the elliptical monoarticular endoprosthetic head. The results of the follow-up of these patients showed that up to the end of the first year after surgery, a progressive elevation in the Modified Harris Hip Score point system as well as a regression to the disappearance of spontaneous and provoked pain regardless of the endoprosthetic design was recorded. The visual analogue scale scores showed a natural decrease in pain sensation with the passing of time from the surgical intervention despite the increasing motor activity.

CONCLUSION: The primary hip joint hemialoplasty is indicated for femoral neck fractures, Garden III or IV, in polymorbid patients over 75 years of age. The elliptical monoarticular endoprosthetic head shows better therapeutic results based on subjective, radiographic and functional criteria during the 12-month follow-up study.


Keywords

femoral neck fracture, elliptical hemiprosthetic head, a biarticular spherical hemiprosthetic head, monoarticular spherical hemiprosthetic head

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DOI: http://dx.doi.org/10.14748/ssm.v49i3.4024

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About The Authors

Nikolay Kolarov
Medical University of Varna
Bulgaria

Orthopedic and Traumatology Clinic, St. Anna University Hospital, Varna

Ruslan Popstefanov
Medical University of Varna
Bulgaria

Orthopedic and Traumatology Clinic, St. Anna University Hospital, Varna

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