BACKGROUND: Hemiarthroplasty with Austin Moore endoprosthesis is an established treatment modality for displaced intracapsular femoral neck fractures in elderly patients above 60years.Technical errors in implantation of the un-cemented Austin Moore are common, and have been associated with complications that may culminate in early prosthetic failure requiring revision surgery. OBJECTIVE: To analyse the frequency of technical errors experienced by surgeons during implantation of uncemented Austin Moore endoprosthesis with the view to improving technique and minimizing early prosthetic failure. MATERIALS AND METHODS: This is a 5year retrospective analysis of radiographs of patients who had hemiarthroplasty with un-cemented Austin Moore endoprosthesis conducted at NKST rehabilitation hospital Mkar in Benue State, North- Central Nigeria with particular reference to intraoperative errors associated with early failure of the prosthesis. Data was analysed using SPSS version 21. RESULTS: A total of 48 patients were operated by 3 orthopaedic surgeons and 35patients met the required criteria for the study.Twenty five intraoperative errors in implantation were identified in 16(45.7%) patients. The commonest intraoperative error was inadequate length of the neck remnant in 13(37.1%) patients followed by inadequate calcar seating in 3 (8.6%) patients, incorrect prosthetic head size in 2(5.7%) patients, intraoperative periprosthetic fracture 2(5.7%) patients and inadequate proximal metaphyseal fill in 1(2.9%) patient. CONCLUSION: Hemiarthroplasty is a technically demanding procedure frequently associated with intraoperative implantation errors. Adequate pre-operative planning, Careful patient selection, proper training of surgeons as well as attention to detail is vital and may minimize technical errors during implantation and consequent early prosthetic failure.
BACKGROUND: Hemiarthroplasty with Austin Moore endoprosthesis is an established treatment modality for displaced intracapsular femoral neck fractures in elderly patients above 60years.Technical errors in implantation of the un-cemented Austin Moore are common, and have been associated with complications that may culminate in early prosthetic failure requiring revision surgery. OBJECTIVE: To analyse the frequency of technical errors experienced by surgeons during implantation of uncemented Austin Moore endoprosthesis with the view to improving technique and minimizing early prosthetic failure. MATERIALS AND METHODS: This is a 5year retrospective analysis of radiographs of patients who had hemiarthroplasty with un-cemented Austin Moore endoprosthesis conducted at NKST rehabilitation hospital Mkar in Benue State, North- Central Nigeria with particular reference to intraoperative errors associated with early failure of the prosthesis. Data was analysed using SPSS version 21. RESULTS: A total of 48 patients were operated by 3 orthopaedic surgeons and 35patients met the required criteria for the study.Twenty five intraoperative errors in implantation were identified in 16(45.7%) patients. The commonest intraoperative error was inadequate length of the neck remnant in 13(37.1%) patients followed by inadequate calcar seating in 3 (8.6%) patients, incorrect prosthetic head size in 2(5.7%) patients, intraoperative periprosthetic fracture 2(5.7%) patients and inadequate proximal metaphyseal fill in 1(2.9%) patient. CONCLUSION: Hemiarthroplasty is a technically demanding procedure frequently associated with intraoperative implantation errors. Adequate pre-operative planning, Careful patient selection, proper training of surgeons as well as attention to detail is vital and may minimize technical errors during implantation and consequent early prosthetic failure.
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Keywords:
Austin Moore prosthesis; Hemiarthroplasty; Technical errors of implantation