Hip Hemiarthroplasty in Patients with Multiple Myeloma: A Retrospective Case Series and Review of the Literature.

Femoral neck fractures in multiple myeloma patients are usually managed with hemiarthroplasty or total hip arthroplasty, depending on the presence of acetabular infiltration. Due to the paucity of dedicated studies, the aim of the present study is to review the clinical outcomes of hip hemiarthroplasty in patients with multiple myeloma and to review the literature regarding the outcomes and survival in these patients' subset.  There were 15 patients (16 cases), with a mean age of 71.7 years, who had myeloma and received hip hemiarthroplasty for displaced femoral neck fractures had their radiographs and clinical data assessed for this study. From those, 13 cases received bipolar and 3 unipolar hemiarthroplasty.  After a mean follow-up of 18.2 months since the time of surgery, 3 cases suffered periprosthetic fractures (18.75%), 4 cases (25%) had heterotopic ossification, and 1 case (6.25%) had acetabular erosion. The 1- and 5-year patient mortality rates for the study cohort were 53.3 and 73.3%, respectively.  Hip hemiarthroplasty remains a viable treatment option in myeloma patients; however, the potentially high morbidity and mortality in these patients should be sensibly understood before the surgery to achieve satisfactory expectations.