Total hip replacement for the treatment of femoral neck fractures. Long-term results.

Objective: To evaluate the outcome of total hip replacement after femoral neck fractures and analyze implant survival rates, complication rates, and mortality after surgery.

Material And Methods: We analyzed 135 primary hip replacements and 8 revision hip replacements performed in 1991-2003 years. Femoral neck fracture was the diagnosis for all primary hip replacements. All patients we analyzed prospectively: special form was filled in for every patient participating in the study. Personal data, operation data, revision date, diagnosis and complications were recorded. Personal patient's identification number was used to determine the death date if it was present, and it was checked if the patient was operated on in other orthopedic centers. Study ended up on 31st of December, 2003.

Results: Total cumulative implant survival rate was 92% and 94% for revision because of aseptic loosening 10 years postoperatively. Stem survival was 95% for revision because of aseptic loosening. Cup survival was 94% for revision because of aseptic loosening. Implant type had no influence on survival rates. Dislocation rate after hip replacement was 10%. Mortality was 25% at the end of the follow-up.

Conclusions: Total hip replacement after femoral neck fracture showed high implant survival and low additional surgery rate. Total hip replacement after femoral neck fracture was associated with high dislocation rate. Low patient's mortality rate was associated with relatively lower mean patient's age.