A study of prospective analysis of unipolar versus bipolar hemiarthroplasty of hip joint in patients with fracture neck of femur


  • Raja X. Christian Fellowship Hospital, Oddanchatram, India
  • Arjun Sarvesh Department Of Orthopaedics, VMKV Medical College, Salem, India
  • Karthikeyen M. Department Of Orthopaedics, VMKV Medical College, Salem, India
  • A. E. Manoharan Department Of Orthopaedics, VMKV Medical College, Salem, India




Hemiarthroplasty, Femur neck, Harris hip score system


Background: Femoral neck fractures occur most commonly in elderly females and are a major cause of morbidity and mortality in this age group and require immediate and appropriate management. Aim of the study was to compare the functional outcome of unipolar Austin Moore's prosthesis (AMP) hemiarthroplasty (HA) and bipolar (BHA) HA with femoral neck fractures using Harris hip score system.

Methods: The study was conducted on 60 patients aged above 50 years with fractured neck of femur admitted in Vinayaka missions Kirupananda Variyar medical college and hospital from August 2017 to August 2019. Patients with femoral neck fracture were allocated randomly to have 30 cases of AMP.

Results: Out of the 60 cases, the patients in the bipolar (nonmodular) HA group II showed better functional outcomes compared to unipolar (AMP) HA group I after six months follow-ups. At 12 months of follow-up, there was no significant difference between group I (AMP) and group II (BHA).

Conclusions: Our study demonstrates, hemiarthroplasty of the hip for femoral neck fractures is a good option in elderly patients. The mortality and morbidity are not high, the operative procedure is simple, complications are less disabling, early weight-bearing and functional results are satisfactory and second surgery are less frequently required.

Author Biography

Raja X., Christian Fellowship Hospital, Oddanchatram, India

assistant professor , annamalaiuniversity, chidambaram


Avery PP, Baker RP, Walton MJ, Rooker JC, Squires B, et al. Total hip replacement and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck: a seven- to ten-year follow-up report of a prospective randomized controlled trial. J Bone Joint Surg Br. 2011:93(8):1045-8.

Baker RP, Squires B, Gargan MF, Bannister GC. Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomized, controlled trial. J Bone Joint Surg Am. 2006:88(12):2583-9.

Bhandari M, Devereaux PJ, Swiontkowski MF, Tornetta P, Obremskey W, Koval KJ, et al. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. a meta-analysis. J Bone Joint Surg Am. 2003:85(9):1673-81.

Bhandari M, Devereaux PJ, Tornetta P, Swiontkowski MF, Berry DJ, Haidukewych G, et al. Operative management of displaced femoral neck fractures in elderly patients. An international survey. J Bone Joint Surg Am. 2005:87(9):2122-30.

Blewitt N, Mortimore S. Outcome of dislocation after hemiarthroplasty for fractured neck of femur. Injury. 1992;23:320-2.

Brooks R. Eurool: the current state of play. Health Policy. 1996;37(1):53-72.

Calder SJ, Anderson GH, Jagger C, Harper WM, Gregg PJ. Unipolar or bipolar prosthesis for displaced intracapsular hip fracture in octogenarians: a randomized prospective study. J Bone Joint Surg Br. 1996:78(3):391-4.

Chan RNW, Hoskinson J. Thompson prosthesis for fractured neck of femur: a comparison of surgical approaches. J Bone Joint Surg Br. 1975;57:437-43.

Chen SC, Badrinath K, Pell LH, Mitchell K. The movements of the components of the Hastings bipolar prosthesis: a radiographic study in 65 patients. J Bone Joint Surg Br. 2003:71(2):186-8.

Christopher C, Ninh AS. Hip dislocation after modular unipolar hemiarthroplasty. J Arthroplasty. 2009;24:768-75.

Cornell CN, Levine D, O’Doherty J, Lyden J. Unipolar versus bipolar hemiarthroplasty for the treatment of femoral neck fractures in the elderly. Clin Orthop Relat Res. 1998:348:67-71.

Mishra AK, Chalise PK, Shah SB, Adhikari V, Singh RP. Comparative study in surgical outcome of intracapsular fracture neck of femur in active elderly patients treated with hemiarthroplasty with Austin Moore’s and bipolar prosthesis. Nepal Med Coll J. 2013;15:81–3.

D’Arcy J, Devas M. Treatment of fracture of the femoral neck by replacement with Thompson prosthesis. J Bone Joint Surg Br. 1976;58:279-86.

Davison JN, Calder SJ, Anderson GH, Ward G, Jagger C, Harper WM, et al. Treatment for displaced intracapsular fracture of the proximal femur: a prospective, randomized trial in patients aged 65 to 79 years. J Bone Joint Surg Br. 2001:83(2):206-12.

Eiskjaer S, Boll K, Gelineck J. Component motion in bipolar cemented hemiarthroplasty. J Orthop Trauma. 1989:3(4):313-6.

Enocson A, Hedbeck CJ, Törnkvist H, Tidermark J, Lapidus LJ. Unipolar versus bipolar Exeter hip hemiarthroplasty: a prospective cohort study on 830 consecutive hips in patients with femoral neck fractures. Int Orthop. 2012:36(4):711-7.

Frihagen F, Nordsletten L, Madsen JE. Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomized controlled trial. BMJ. 2007:335(7632):1251-4.

Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br. 1961;43(4):647-63.

Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg. 2007:51(4):737-55.

Hedbeck CJ, Blomfeldt R, Lapidus G, Törnkvist H, Ponzer S, Tidermark J. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the most elderly patients with displaced femoral neck fractures: a randomized, controlled trial. Int Orthop. 2011:35(11):1703-11.






Original Research Articles