Evaluating Surgical Outcomes of Cementless Total Hip Replacement in old Patients

Cementless total hip arthroplasty is an accepted alternative in young patients، but in older individuals، its use is still controversial. To evaluate the clinical and radiological outcome of cementless hip replacement in patients aged 65 years or older using proximally tapered femoral stem implants. In this cross- sectional study، 162 patients (173 hips) with a mean age of 69. 38±3. 8 years (range 65-80 years) who were candidates for and underwent cementless total hip replacement with polyethylene-metal and were followed up for 3-7 years. were entered “Harris Hip Score” (HHS) was applied to assess the functional outcomes. All the patients were screened for early complications (thrombophlebitis of the lower extremity، early dislocation، hematoma، surgical site infection)، and late complications (aseptic loosening، dislocation، osteolysis، and need for revision) at 3 and 6 weeks، 3 and 6 months، 1 year post-surgery، and annually thereafter. Patients were followed for an average of 5. 5 years (range 3. 1-7. 3 years). Six hips (3. 5%) experienced early-onset complications (1 case of hematoma، 2 cases of symptomatic thrombophlebitis، and 3 cases of premature hip joint dislocation)، and 2 cases (1. 1%) of delayed-onset dislocation. Not case of aseptic loosening or osteolysis was observed. Mean pre-operative “Harris Hip Score”، was 54. 3 and increased significantly to 84. 6، and 87. 8، on immediate and latest follow up visits، respectively. Cementless total hip arthroplasty، in elderly patients، i. e، 65 years and older، using new generation proximally tapered prosthetic femoral implants، and wear resistant acetabular cups with polyethylene inserts، is a low risk surgery with satisfactory results in short to moderate follow up study.