The Austin Moore Prosthesis (AMP) is a recognised treatment option in the management of displaced intracapsular femoral neck fractures in elderly patients. Peri-prosthetic femoral fractures are a potential complication of both cementless and cemented hemiarthroplasty and can occur intra-operatively or at any stage following implant insertion.

Over a two-year period, 244 patients underwent hemiarthroplasty for a displaced intracapsular femoral neck fracture. Seventy patients had an AMP inserted whilst 174 patients were treated using a cemented Thompson stem. All of the AMP’s were inserted by, or under the supervision of an orthopaedic consultant.

Five patients (7%) from the AMP group sustained a periprosthetic femoral fracture. Four required revision surgery. The remaining case was managed non-operatively.

When compared to the cemented Thompson hemiarthroplasties performed over the same time period, despite the operating time being significantly less, the number of periprosthetic femoral fractures was significantly greater with the AMP. Furthermore, the early mortality rate was significantly higher for the AMP group who, were also significantly older and more likely to require postoperative blood transfusion. There was no significant difference in gender or ASA grade between the two groups.

These findings suggest that for displaced intracapsular femoral neck fractures in elderly patients, when hemiarthroplasty is the treatment of choice, a cemented prosthesis is preferable.