The Austin Moore prosthesis
The Austin Moore prosthesis
Hip fractures are the second most common fractures in older people, surpassed only by wrist fractures. Undoubtedly, their incidence will increase due to the increase in life expectancy, with the repercussions this will have on both health and the economy. That is why the different treatment alternatives have been and continue to be the subject of study and evaluation. In particular, hemiarthroplasty, both cemented and uncemented, is an accepted treatment for displaced medial hip fractures in elderly patients with low functional demand. Numerous reports have been published on complications related to total hip replacement; however, there are fewer articles on hemiarthroplasty.
The Austin Moore prosthesis is used in hip hemiarthroplasties. Its design allows the articular cartilage of the acetabulum to be respected.
Characteristics
Characteristics of the Austin-Moore prosthesis:
- The geometry of the stem section is rectangular, allowing better anchorage against torsional stress.
- Made of Titanium Alloy (Ti6Al4V).
- Designed with windows, to favor bone growth through them, allowing a very effective anchorage of the prosthesis.
- Availability of support in femoral calcar for transmission of loads to the area of the minor trochanter.
- Non-cemented fixation.
Austin Moore hemiarthroplasty with prosthesis is a valid alternative for patients with displaced medial fracture, low functional demand and poor general condition, as it is a fast procedure that eliminates pain and allows early mobility.
Conclusions
The treatment of femoral neck fractures has been controversial for many years. Treatments have ranged from internal reduction and osteosynthesis, through hemiarthroplasty to total hip replacement. Most orthopaedic surgeons agree that joint replacement, either partial or total, is the treatment of choice in older people with displaced medial fractures. Indications for hemiarthroplasty or total arthroplasty are still under discussion, mainly in elderly patients with low functional demand. In active people, there is no doubt that a total hip replacement, regardless of the fixation shape or surface chosen, is the procedure of choice.
Ravikumar and Marsh conducted a study involving 275 active, medially displaced fracture patients over 65 who were randomly assigned to three treatment options: reduction and osteosynthesis, hemiarthroplasty, or total hip replacement. At one year of follow-up, 27% of hemiarthroplasty patients suffered pain and none of those undergoing total hip replacement reported pain.
The criteria for indicating one form of treatment or another are well defined. Hemi-arthroplasty is reserved for ambulatory patients who do not leave their homes or geriatric homes, with low functional demand, extrapyramidal neurological alterations or dementia and low life expectancy due to clinical condition. The strict selection of patients eligible for this type of treatment is reflected in the non-existent revision rate due to acetabular erosion. Although this complication, with its consequent picture of pain, is described in patients treated with hemiarthroplasty, we believe that, in the majority, it is due to having indicated this implant in active patients.
Dr. Leopoldo Maizo - Orthopedic Surgeon
Firma diseñada por @themonkeyzuelans, contáctalos vía Discord "themonkeyzuelans#9087"
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