Cemented versus uncemented Thompson's prostheses: a functional outcome study

Abstract

One hundred and one elderly patients (90 female and 11 male) with a mean age of 83.5 years (range 69-100) were treated for intracapsular femoral neck fracture by Thompson's prosthesis. The prosthesis was fixed in the femoral shaft using Palacos cement in 23% and was inserted uncemented in 77%. We compared the following pre and postoperative variables in each group; mobility of the patient, their activity, walking aids and postoperative thigh pain. We also studied the pre and postoperative hip X-rays. Our patients did well in both groups. We conclude that there is no statistically significant difference between the variables in the two groups. Thompson's prosthesis can be inserted uncemented. Patients with radiological loosening of the prosthesis are not necessarily symptomatic. Intra and postoperative complications were similar to other published series of hip prostheses. The femoral neck osteotomy for Thompson's prosthesis can be performed safely well above the calcar femoris without detrimental complications. The original inter-trochanteric cut Thompson described is not necessary for acute fractures. This consequently makes revision of failed Thompson's prosthesis easier.