Hip fractures are injuries that affect not only the joint of an elderly person, but also the patient’s survival. Four surgical options are well supported in the orthopaedic literature: reduction with internal fixation, different types of unipolar hemiarthroplasty, bipolar hemiarthroplasty, and total hip arthroplasty.

The aim of this study is to assess Thompson hemiathroplasty as a treatment for these lesions and their complications. Between January 1999 and September 2003, we treated 213 patients who suffered femoral neck fracture, 119 patients of them were treated with Thompson cemented prosthesis. The average age was 82.6 years. The average time between admission and surgery was 3.1 days. The time between surgery and discharge from hospital was 7 days on average. First year mortality after fracture was assessed (25%) and functional results were compared with the preoperative status. The mean follow-up was 36 months. Independence in daily activities before and after fracture compared according to a modified scored questionnaire, based on the lower extremity measure, which was easy to administer by telephone interview. Of the 96 patients that we contacted 48 were alive and available for follow-up. 11 patients (11.4%) had clinical and surgical complications. According to functional results 28.5% of the patients reached a score between 85 and 99 points (very good), 40.8% had a score between 55 and 84 points (good) and 18.4% had a fair outcome in postoperative time.

We consider that Thompson hemiarthroplasty must remain as a surgical option in the treatment of femoral neck fractures in the elderly. The procedure provides rapid return to preoperative functional status for the majority of the patients (71.3% in the present study) with low surgical cost.

Objective: Review study of the long-term results of Mittelmeier’s high tibial osteotomy for the treatment of degenerative osteoarthritis of the knee.

Patients – Mehod: 110 patients (93 women – 17 men) aged from 50 to 75 years (average 65 years) with knee osteoarthritis of stage II-IV at Ahlback’s grading system, were treated with high tibial osteotomy, in a 15 year period (1988–2002). An overall of 114 osteotomies were performed to the abovementioned patients. All the osteotomies were performed with the same surgical technique, the Mittelmeier’s biplane osteotomy with the use of a specially designed blade plate. 87 patients (73 women – 14 men) were followed-up for a mean time of 10 years (2–14 years). The parameters that evaluated were the knee function, the axial alignment, the complication rate and finally the time that the osteotomy was converted to total arthroplasty.

Results: According to IOWA knee score the result was excellent in 64 patients and good in 15 patients, whereas 9 patients had a poor end result. 3 patients needed a total knee arthroplasty after a meantime of 8 – 10 years. In addition, 2 more patients fulfill the indications of a total arthroplasty. The main complications that occurred were: anterior tibia compartment syndrome in 1 patient, superficial infection in 2 patients, 1 delayed union and 1 mechanical failure of the osteosynthesis. Additionally, in 36 patients there were problems at the site of the fibular osteotomy (injury or entrapment of the superficial peroneal nerve in 12 patients, unremitting pain in 24 patients).

Conlusions: The high tibial osteotomy is an effective though technically demanding method for the operative treatment of the osteoarthritis of the medial compartment of the knee joint.