AUSTIN MOORE PROSTHESIS IN THE MANAGEMENT OF FRACTURE NECK OF FEMUR IN AN ELDERLY POPULATION.

Abstract

Introduction: Intracapsular fractures of the proximal femur form a major share of fractures in the 77 elderly. Hip replacement arthroplasty (partial or total) is emerging as a most viable treatment option, and in that, hemiarthroplasty with the Austin Moore Prosthesis is among the most commonly employed. In our study, we have made an attempt to assess the functional status at long term follow up after hemiarthroplasty with the AMP, used in the treatment of fracture neck of femur in the elderly population, and to substantiate the use of the prosthesis in modern day orthopaedic practice. Materials and : A retrospective study was carried out in patients above the age of 60 years, who had been diagnosed with non-pathological fracture neck of femur, treated operatively with hemiarthroplasty using the Austin Moore prosthesis in a tertiary care centre. A minimum follow up period of two years was considered. All the patients were evaluated clinically, and wherever possible, radiologically. Functional outcome was assessed based on the Harris Hip scoring system, and the results were analysed. Radiologically, an attempt was made to assess, among others, the amount of protrusio acetabuli at follow up, and femoral offset changes following hemiarthroplasty with the AMP. Results: In our study, we observed a positive functional outcome (excellent or good) in 9(45%) patients, with fair result in 6(30%) and poor in 5(25%). However, when pain alone was taken as criteria for assessment, upto 14(75%) patients had none to slight pain at follow up, and only 1(5%) patient had marked pain. Walking distance was significantly reduced in 6(30%) patients, who were either confined indoors or bedridden, but in only 1(5%) of them, the cause for the decreased ambulatory status was implant or procedure related (pain). Among the complications, 1 patient had a post-operative periprosthetic fracture that healed subsequently, 2 patients had marked osteolysis around the stem of the prosthesis, and only 1 patient had a radiological evidence of protrusio acetabuli. Discussion: Hemiarthroplasty with Austin Moore Prosthesis for fracture neck of femur remains a fairly good treatment option in elderly patients.