Prospective study of the functional outcome of uncemented bipolar hemiarhroplasty in displaced fracture neck of femur in elderly
Keywords:Fracture neck of femur, Bipolar prosthesis, Hemiarthroplasty, Harris hip score
Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity, mortality and loss of independence. To avoid the drawbacks of internal fixation and for early mobilization, hemiarthroplasty is performed in elderly. The bipolar prosthesis was developed to overcome the shortcomings of the unipolar fixed-head prosthesis. An additional site of motion would be expected to decrease the amount of loosening, dislocation, and head migration. The aim of the study is to assess the functional outcome of the patients with fracture neck of femur treated with bipolar hemiarthroplasty.
Methods: In this study, 20 patients above the age of 60 years with acute displaced fracture neck of femur underwent hemireplacement arthroplasty with bipolar prosthesis in Department of Orthopaedics, KIMS, Bangalore. The patients were followed up on 6th, 12th, 18th, 24th week post operatively. Functional outcome was assessed with Harris hip score.
Results: In our study, mean average age was 72.3 years with predominantly female patients with 75% of the patients with left sided fracture. 95% of the patients had slight or no pain, 85% of patients had slight or no limp. 50% of the patients could walk without support, 65% of the patients could walk a distance of 6 blocks or more. Average Harris hip score was 82%.
Conclusions: These results suggest functional outcome following bipolar hemiarthroplasty is good. Early mobilisation, pain free hip and with good level of activity is obtained following bipolar hemiarthroplasty.
Thorngren KG, Hommel A, Norrman PO, Thorngren J, Wingstrand H. Epidemiology of femoral neck fractures. Injury. 2002;33(Suppl 3):C1-7.
Koval KJ, Zuckerman JD. Hip Fractures: I. Overview and Evaluation and Treatment of Femoral-Neck Fractures. J Am Acad Orthop Surg. 1994;2(3):141-9.
Boyd HB, Salvatore JE. Acute fractures of the femoral neck: Internal fixation or Prosthesis? JBJS 1964;46:1066-8.
Kulkarni GS. Pathology of fracture neck of the femur. Clin Orthop India. 1987;1;92-6.
Evarts CM. Endoprosthesis as the primary treatment of femoral neck fractures. Clin Orthop. 1973;92:69-76.
Ingalhalikar VT, Kumta S. Fracture neck femur anatomical and biomechanical aspects. Clin Orthop India. 1987.
Seth MK. Stress fractures of the neck of femur. Clin Orthrop India. 1987;1:105-9.
Rodriguez-Buitrago A, Attum B, Cereijo C, Yusi K, Jahangir AA, Obremskey WT. Hemiarthroplasty for Femoral Neck Fracture. JBJS Essential Surgical Techniques. 2019;9(2):13.
Madanat R, Mäkinen TJ, Ovaska MT, Soiva M, Vahlberg T, Haapala J. Dislocation of hip hemiarthroplasty following posterolateral surgical approach: A nested case-control study. Int Orthop. 2012;36(5):935-40.
Ninh CC, Sethi A, Hatahet M, Les C, Morandi M, Vaidya R. Hip dislocation after modular unipolar hemiarthroplasty. J Arthroplasty. 2009;24(5):768-74.
Salvatti EA, Wilson PO. Long term results of femoral head replacements JBJS. 1972;54:1355-6.
Bavadekar AV, Manelkar KR. Hemiarthroplasty of the hip in the treatment of intracapsular fracture neck of the femur state of the art and an appraisal. Clin Orthop India. 1987;1:43-52
La Belle, Colwill JC. Bateman bipolar hip arthroplasty for fracture neck of femur, a five to ten year of study”, Swanson AB Clinorthop. 1990;251:20.
Saxena PS, Saraf JK. Moore Prosthesis in fracture neck of femur. Indian J Orthop. 1978;12:138-45.
Cornell CN, Levine D, O’Doherty J, Lyden J. Unipolar Versus bipolar hemiarthroplasty for the treatment of femoral neckfractures in the elderly. Clin Orthop Relat Res. 1998;348:67-71.
Calder SJ, Anderson GH, Jagger C, Harper WM, Gregg PJ. Unipolar or bipolar prosthesis for displaced intracapsular hip fracture in octogenarians:a randomised prospective study J Bone Joint Surg Br. 1996;78:391-4.
Sherwani MK, Asif N. Bipolar hemiarthroplasty of the hip - a reviw of 80 cases, Indian J Orthop. 1999;33:23-5.
Lestrange NR. Bipolar arthroplasty for 496 hip fracture. CORR. 1990;251:07-19.
Gilberty RP, Hemiarthroplasty of the hip using lo fricition bipolar endoprosthesis. Clin Orthop. 1983;175;86-92.
Mukherjee DL, Puri HC. Early hemiarthroplasty for fresh fractures of the neck of the femur in geriatric patients. Indian Journal of Surgery. 1986;48:77-80.