Functional assessment of bipolar hemiarthroplasty versus total hip replacement in trans cervical neck fracture of femur in elderly patients a prospective observational study

Subith S.; Abhijit Charthal; Shubham Dakhode; Ketan Naik

doi:10.18203/issn.2455-4510.IntJResOrthop20231175

Authors

Subith S. Department of Orthopaedics, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India
Abhijit Charthal Department of Orthopaedics, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India https://orcid.org/0000-0001-8755-533X
Shubham Dakhode Department of Orthopaedics, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India https://orcid.org/0000-0003-2071-0002
Ketan Naik Department of Orthopaedics, Topiwala National Medical College and BYL Nair Hospital, Mumbai, Maharashtra, India https://orcid.org/0000-0003-3502-4267

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20231175

Keywords:

Total hip arthroplasty, Bipolar hemiarthroplasty, Total Modified Harris Hip score, Neck of femur fracture, Elderly Indian patients

Abstract

Background: Bipolar hemiarthroplasty and total hip arthroplasty are widely accepted methods of treatment for displaced femoral neck fracture in elderly patients. This study is to compare the functional outcomes of bipolar hemiarthroplasty and total hip arthroplasty in such patients.

Methods: This is a prospective study in which data of all patients with age more than 60 with trans cervical neck of femur fracture undergoing total hip arthroplasty and bipolar hemiarthroplasty in a tertiary care centre in Mumbai is studied. They were followed up and compared with the Modified Harris Hip Score. The results were compared between the two groups for statistical significance.

Results: There was a significant difference seen in pain and gait at 6 and 12 months between two groups with better scores in the total hip arthroplasty group. Better functional activities were seen at 3 and 6 months in the total hip arthroplasty group. A significant difference was seen in the Total Modified Harris Hip Score at 3, 6 and 12 months and was better in the total hip arthroplasty group as compared to the hemiarthroplasty group.

Conclusions: Bipolar hemiarthroplasty is the preferred approach after a displaced femoral neck fracture in the elderly population, but due to potential complications like inguinal pain and low functional outcome, total hip replacement should be considered as the first line of surgical management for the neck of femur fracture in such patients. It has been found to have a good functional outcome, fewer gait disturbances and less post-operative pain.

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