Irfan M RajputDow University of Health science, Pakistan
Title: Mid-term results of total hip arthroplasty for failed aseptic austin moore hemiarthroplasty: clinical and radiological outcome
Introduction: Fractures neck of femur very common in the elderly. Nowadays the indication for Austin Moore Hemiarthroplasty (AMH) is very limited, particularly in non-ambulatory, low-demand, and multiple comorbid patients. In our country, because of the low cost of AMH, its use is very common, which is due to inappropriate selected patients lead to failure of AM hemiarthroplasty
Method: This is a prospective study to evaluate the five-year outcome of total hip arthroplasty (THA) in patients with failed AMH. From June 2014 to November 2020, all the patients who had AMH were evaluated and candidates with failed procedures were sorted out. From these, we selected candidates for THA and all these patients were followed up for five years to assess clinical and radiological outcomes. Harris Hip Scores (HHS) were calculated to evaluate the functional outcomes.
Results: We selected 28 patients for THA with a mean age of 61.1+3.3 years, where 57.14% (n=16) were females and 42.86% (n=12) males. Early postoperative complications were pain and superficial wound infection managed appropriately. Femoral loosening (n=14, 50.0%) and acetabular erosion (n=7, 25.0%) were the most frequent indications. Excluding the two patients those died due to systemic causes disease, HHS evaluation at one year showed 15 (53.6%) excellent, 9 (32.1%) good, 1 (3.6%) fair, and 1 (53.6%) poor., while at 5-year postoperative analysis, it showed 6 (21.4%) excellent results 18 (64.3%) good, 1 (3.6%) fair, and 1 (3.6%) poor results. The mean HHS was found to be 84.7±6.7 at the last follow-up. The radiological assessment showed no complications.
Conclusion: AMH is the procedure of choice for the neck of femur fractures of elderly, in developing countries and used for the active population as well which has more chances of future complications, requiring revision. The most common complications with AMH are loosening of the prosthesis and acetabular erosion. THA after failed AMH is an excellent treatment strategy to control pain and restore function and mobility.
Irfan Rajput has completed his fellowship (FCPS) from College of Physicians & Surgeons of Pakistan in 2013. He worked as a Senior Registrar Orthopaedics, The Indus Hospital Karachi from 2013 to 2014. He did fellowship hip & knee replacement surgery from Pakistan Arthroplasty Society in 2015 then went for International travelling fellowship in Adult Knee Reconstruction and Trauma, University Hospitals of Leicester, NHS trust, UK. Now he is working as an Assistant Professor Orthopaedics at Dow University of Health Sciences Karachi, Pakistan.