الفهرس 
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Abstract
Introduction: Displaced intracapsular fractures of the neck of the femur in the elderly patients are commonly treated by hemiarthroplasty. Orthopaedic surgeons are divided as to the relative merits of cemented versus uncemented prostheses in these patients. Cementing the prostheses provides more secure fixation and may result in less residual pain and better function. However, the insertion of cement complicates the operation and carries the risk of cardiovascular collapse when the cement introduced into the femur.
Aim of work: To evaluated the outcome and patient satisfaction following hemiarthroplasty for displaced fractures of neck of the femur.
Patients and methods: 66 patients to determine whether there was any difference in outcome between treatment with a cemented Thompson hemiarthroplasty and an uncemented Austin-Moore prosthesis. The patients were randmoized with respect to number of inclusion and exclusion criteria into two groups: group A (Cemented Thompson unipolar hemiarthroplasty) and group B (cementless Austin-Moore unipolar hemiarthroplasty). All the patients were operated by senior surgeons or at least supervised by them. The surgical approach used was either posterior approach (Southern) approach or direct lateral approach (Hardinge) according to the surgeon’s preferences. The surgery time, intra-operative, post-operative blood and the amount of blood transfusion related to the procedure was noted. The mobilization and rehabilitation programs started after drain removal and progressed gradually according to patients’ tolerance and compliance. In the cemented Thompson group 36 patients (mean age; 71.78) were included with minimum follow up of 12 months. Twenty-one patients were female and 15 were males. In the cementless Austin-Moore group 30 patients (mean age; 68.3) were included with minimum follow up of 12 months. Eighteen patients were female and 12 were males.
Results: The use of cemented Thompson prosthesis increased the mean surgery time 78.3 minutes; (p<0.001) and increased the average amount of intra-operative blood loss 520 ml; (p<0.001) in comparison to cementless group. However, no significant difference as regard the post-operative blood loss in the drain 225 ml and the average amount of blood transfusion 557 ml. The Mean surgical time; (57.5 minutes) and the average amount of intra-operative blood loss; 415 ml were less in the cementless group. However, no significant difference as regard both the post-operative blood loss in the drain; 240 ml and the average amount of blood transfusion; 550 ml related to the procedure.
Conclusions: The cemented Thompson hemiarthroplasty led to less pain in the hip, improved return of mobility and a reduced hospital stay compared to an uncemented Austin-Moore prosthesis. There was no increase in complications or mortality related to the use of cement.