Intra-operative implantation errors during hemiarthroplasty

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.

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.

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.

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.

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.