THR as a Possibility for Fracture Repair

Total hip replacement (THR) is a well-established procedure for the treatment of disabling disorders of the coxofemoral joint. It was originally developed to treat pain associated with osteoarthritis secondary to hip dysplasia in order to provide a pain-free joint and restore biomechanical function. Several THR systems, both cemented and cementless, have been developed and clinically tested over the last four decades. The success rate of THR has increased over the years because of improvement in implant design and application technique, with overall outcomes of both cemented and cementless THA reported to be good, with complication rates between 7% and 20% for cemented THA, and 5–17% for cementless THA. Most complications are solved with surgical revision, while THA failure with explantation is reported to be 1% to 5%. Increase in reliability of THR systems has lead to expansion of its indication to treatment of different disorders of the coxofemoral joint other than hip dysplasia, such as coxofemoral luxations, fractures of the femoral head or neck, malunions of the acetabular fractures and malunion of femoral fractures.

Records of 1824 consecutive Zurich Cementless THRs performed between August 1997 and May 2016 were retrospectively analyzed to evaluate arthroplasties performed in cases of femoral head/neck fractures and acetabular or femoral malunions, finding 62 cases (3.4%).  [...]