NOF Elderly

Question 1

What would make you favour a THR over a hemiarthoplasty

Answer 1

Able to walk independently out of doors with no more than the use of a stick

Do not have a condition or comorbidity that makes the procedure unsuitable for them

Are expected to be able to carry out activities of daily living independently beyond 2 years.

Question 1

What is a proven femoral stem

Answer 1

<10% revision rate over 10 years

Question 2

Why uncemented femoral stem

Answer 2

Bone preservation: Uncemented stems may help preserve bone.

Long-term durability: Uncemented stems may be more durable in the long term.

Note: Uncemented stems in patients with osteoporotic bone can lead to perforation of femoral cortex and fracture

Question 3

Why are cemented femoral stems used

Answer 3

Surgeon control: Cemented stems may give surgeons more control over the position of the stem.

Longer survivorship: Cemented stems may have a longer survivorship than uncemented stems.

Question 4

What is the nottingham hip fracture score

Answer 4

Reliable in prediciting 30 day and 1 year mortality:

Age

Sex

AMTS

Haemoglobin on admission

Residence (living in institution)

Co-morbidities

Active malignancy

Question 5

Important questions to ask in NOF Hx

Answer 5

Allergiese
Medications including blood thinners
Past medical history
Last ate
Head Injury
Events of injury, further injury, head injury, long lie?
POA
Functional status?
Bloods
ECG
CXR

Question 6

What are the approches for NOF fixation?

Answer 6

Modified Hardinge