Short-Term Radiographic Result of Cementless Hemiarthroplasty Using Tapered Wedge-Shaped Femoral Component in Older Patients with Femoral Neck Fractures

Aasis Unnanuntana MD*, Hanchai Unkanawarapan MD*

Affiliation : * Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Objective : To evaluate the short-term radiographic results of cementless hemiarthroplasty using a tapered wedge-shaped femoral component in elderly patients with displaced femoral neck fracture. Specifically, the authors assessed the prevalence of intraoperative crack and rate of subsidence associated with tapered wedge-shaped femoral component in patients with femoral neck fracture. Material and Method: Medical records were reviewed of 154 patients that underwent cementless hemiarthroplasty using tapered wedge-shaped femoral component between January 2009 and December 2012. Ninety-five patients had immediate postoperative and 12-month or greater postoperative follow-up radiographs available for reviewing. The average length of radiographic follow-up was 29.8 months. Radiographs from these 95 patients were reviewed to evaluate for intraoperative crack, stability, and subsidence of the femoral component.
Results : From 154 patients, 30 (19.5%) had intraoperative crack of the femoral neck, all of whom were successfully treated with cerclage wiring. The majority of intraoperative crack (86.7%) occurred in patients who were implanted with Corail® stem. Five patients (5.3%) had subsidence greater than 2 mm. Mean subsidence in these five patients was 5.4 mm. No patient was revised due to femoral stem loosening.
Conclusion : Cementless hemiarthroplasty using a tapered wedge-shaped femoral component design is a viable option for treating femoral neck fracture in elderly patients. However, tapered wedge-shaped femoral component, particularly the Corail® stem, is associated with a high incidence of intraoperative crack in these patients population.

Keywords : Cementless, Uncemented, Hemiarthroplasty, Tapered, Wedge-shaped femoral component, Femoral neck fracture

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