Abstract
Uncemented femoral components of hip arthroplasty are believed to have a higher risk of subsidence in older patient groups. This has not been conclusively related to a poorer outcome of the arthroplasty over time.
Our aim is to measure prevalence of subsidence in uncemented femoral components in a population of patients over 75 years of age and correlate with clinical outcome measures.
Patients over 75 years of age from Jan 2002 to Aug 2009 had uncemented THJR at the discretion of the senior surgeon (RF). Pre-operative Charnley Hip Classification and Harris Hip Scores were recorded, as were HHS at 6 weeks and 1 year post-operatively for all patients. Post-operative radiographs were retrospectively reviewed and presence of subsidence quantified at 1 year and subsequent follow-ups.
83 patients had 92 uncemented THJR in the designated time frame. 5 pts were lost to follow-up or died within 12 months after operation leaving 78 patients and 87 hips for assessment. Average pre-op HHS 40.6 (13.1–64.6) and Charnley Classification noted (A 55.4 %: B 30.4%: C 14.1%). 12/87 (13.8%) hips had subsidence > 2mm (2 – 18mm) noted at 1 year radiographs. Average HHS for those with >2mm subsidence was 89.4 (69.7–100; median 93.9) compared to 90.7 (64.7 – 100; median 91.9) for those with < 2mm subsidence. 4 patients underwent revision procedures during follow-up period, all for periprosthetic fracture following falls.
In appropriately selected patients over 75 years of age, the presence of subsidence in uncemented femoral components does not seem to result in poorer outcome measures.
