Published: 2021-04-26

Evaluation of functional outcome of displaced fracture neck of femur in elderly treated with cemented bipolar prosthesis by modified Harris hip score

Shivakumar B. Kerakkanavar, Deepak P. Kaladagi, Nagesh B. Sanakal, Pundaleekappa S. Kaladagi, Praveenkumar A. Hongal


Background: The current research was conducted to determine the functional outcome of the displaced fracture neck of femur in elderly patients treated with cemented bipolar hip prosthesis.

Methods: The present research was a prospective study of 44 cases of displaced fracture neck of femur admitted to our institute between October 2017 and October 2019. Cases were chosen on the basis of inclusion and exclusion criteria. Cases were surgically treated with cemented bipolar hip hemiarthroplasty and functional findings were recorded with modified Harris hip score.

Results: In our series of 44 cases there were 30 females and 14 males, with a maximum age of 92 years, minimum age of 65 years, and the average age was 72.72 years. At one-year follow-up, the average modified Harris hip score was 86.75% (maximum score of 95 and a minimum score of 66), overall, 20 patients (45.46%) achieved excellent, 16 patients (36.36%) achieved good, 5 patients (11.36%) achieved fair and 3 patients (6.82%) achieved poor results. 81.82% of the patients returned to the pre-fracture level of activity and independent ambulation. Patients had few complications like limb length discrepancy, 36.3% of patients had limb lengthening between 1 to 1.5 cm.

Conclusions:  In elderly patients with displaced neck femur fractures, cemented bipolar hip prosthesis provides good functional outcome. However further study for a longer period in a larger sample with a direct comparison between the cemented versus uncemented groups is required.


Bipolar prosthesis, Femur neck fracture, Harris hip score

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Thorngren KG, Hommel A, Norrman PO, Thorngren J, Wingstrand H. Epidemiology of femoral neck fractures. Injury. 2002;33(3):C1-7.

Swiontkowski MF. Intracapsular fractures of the hip. J Bone Joint Surg Am. 1994;76(1):129-38.

Iorio R, Healy WL, Lemos DW, Appleby D, Lucchesi CA, Saleh KJ. Displaced femoral neck fractures in the elderly: outcomes and cost-effectiveness. Clin Orthop Relat Res. 2001;(383):229-42.

Lu-Yao GL, Keller RB, Littenberg B, Wennberg JE. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am. 1994;76(1):15-25.

Parker MJ. Fractures of the neck of the femur. Trauma. 2008;10(1):43-53.

Schmidt AH, Leighton R, Parvizi J, Sems A, Berry DJ. Optimal arthroplasty for femoral neck fractures: is total hip arthroplasty the answer? J Orthop Trauma. 2009;23(6):428-33.

Hopley C, Stengel D, Ekkernkamp A, Wich M. Primary total hip arthroplasty versus Prosthesis for displaced intracapsular hip fractures in the older patient systematic review. BMJ. 2010;340:c2332.

Hedbeck CJ, Enocson A, Lapidus G, Blomfeldt R, Törnkvist H, Ponzer S et al. Comparison of bipolar hemiarthroplasty with total hip arthroplasty for displaced femoral neck fractures: a concise four-year follow-up of a randomized trial. J Bone Joint Surg Am. 2011;93(5):445-50.

Kumar P, Sen R, Aggarwal S, Agarwal S, Rajnish RK. Reliability of Modified Harris Hip Score as a tool for outcome evaluation of Total Hip Replacements in Indian population. J Clin Orthop Trauma. 2019;10(1):128-30.

Marya SK, Thukral R, Singh C. Prosthetic replacement in femoral neck fracture in the elderly: results and review of the literature. Indian J Orthop. 2008;42(1):61-7.

Krishnan H., Yoon TR., Park KS. Bipolar Hemiarthroplasty in patients presenting with displaced intracapsular femoral neck fractures-A Comparison of cemented and uncemented prosthesis placement. Malaysian Orthop J. 2010;4(1):25-31.

Hinchey and Day. Primary prosthetic replacement in fresh femoral neck Fractures. J Bone Joint Surg. 1960;42B:633-40.

Ford LEM. Use of Moore self-locking Vitallium

prosthesis in acute fractures of the femoral neck. J Bone Joint Surg. 1965;47A:832-41.

Moshein J, Alter AH, Elconin KB, Adams WW Jr, Isaacson J. Transcervical fractures of the hip treated with the Bateman bipolar prosthesis. Clin Orthop Relat Res. 1990;(251):48-53.

Lestrange NR. Bipolar arthroplasty for 496 hip fractures. Clin Orthop Relat Res. 1990;(251):7-19.