A surgical procedure performed in elderly patients with femoral neck fracture in which the head of the thigh bone is replaced with a prosthesis. It aims to restore early ambulation and a pain-free hip.
Indication
- Displaced femoral neck fractures in elderly patients
- Avascular necrosis (loss of blood supply) of the femoral head
- Need for rapid mobilization in patients at high risk of prolonged bed rest
- Cases in which the hip socket (acetabulum) is generally preserved
- Selected patients who are not suitable for, or are at high risk for, total hip replacement
Preparation
- Pre-anesthesia blood tests, ECG and chest X-ray when needed
- Optimization of accompanying conditions (heart, diabetes, kidney)
- Adjustment of blood thinners with the doctor's approval
- Skin preparation of the surgical site and screening for infection
- When possible, planning surgery within a short time (1-2 days) of the fracture
How it's performed
- General or regional anesthesia is administered by the anesthesiologist
- The patient is positioned and the surgical field is prepared sterilely
- The hip is approached through a lateral or posterior approach
- The fractured femoral head is removed
- A metal prosthetic stem and head are placed at the top of the femur (cemented or uncemented)
- Joint motion is checked, the tissue layers are closed and sutured
Post-procedure
- Hospital stay is generally 3-7 days
- Anticoagulants and physical therapy when indicated
- Gradual weight-bearing and standing with a walker per the doctor's recommendation, starting on the first day
- Restrictions on demanding movements (e.g., crossing legs, deep squatting) may be advised in the first 6-8 weeks
- Evaluation of the prosthesis and hip joint with regular follow-up X-rays
Risks
- Wound and prosthesis infection
- Blood clots in the leg veins (deep vein thrombosis) and pulmonary embolism
- Prosthesis dislocation (especially in the early weeks during demanding positions)
- Wear of the hip socket and loosening of the prosthesis over time
- Nerve or vascular injury, bleeding, anesthesia complications
FAQ
How does it differ from total hip replacement?
In partial replacement only the head of the femur is replaced and the hip socket is left in place. In total replacement both sides are renewed. Partial replacement is generally preferred in elderly patients with femoral neck fracture.
When can I stand up after the operation?
Most patients are helped to stand with a walker and a physiotherapist on the day after surgery. Early movement reduces the risk of clots and lung and muscle problems.
How long does the prosthesis last?
Partial hip prostheses can function for many years, although this varies between individuals. If wear or socket-related problems develop, conversion to a total hip replacement may eventually be required.
Which movements should I avoid?
In the first 6-8 weeks deep sitting, crossing the legs, leaning forward and excessive rotation can increase the risk of dislocation. Your doctor and physiotherapist will provide individualized guidance.
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