Evaluation of functional outcome of cemented bipolar prosthesis in femoral neck fracture in old age patients

Bappy Kumer Biswas; Kanta Rani Das; Mushfique Manjur; M. Humayun Kabir; M. Sahidur Rahman Khan; M. Tanvir Ahasan Juglol Khan; M. Ziaur Rahman; Sabbir Ahmed; Ananta Kumar Bhakta

doi:10.18203/issn.2455-4510.IntJResOrthop20243882

Authors

Bappy Kumer Biswas Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh https://orcid.org/0009-0002-2560-0662
Kanta Rani Das Department of Obstetrics and Gynecology. Mugda Medical College Hospital, Dhaka, Bangladesh
Mushfique Manjur Department of Orthopaedic Surgery, Delta Medical College Hospital, Dhaka, Bangladesh
M. Humayun Kabir Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh
M. Sahidur Rahman Khan Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh
M. Tanvir Ahasan Juglol Khan Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh
M. Ziaur Rahman Department of Hand and Microsurgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh
Sabbir Ahmed Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh
Ananta Kumar Bhakta Department of Hand and Microsurgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20243882

Keywords:

Femoral neck fracture, Elderly, Cemented bipolar prosthesis, HHS, Hemiarthroplasty

Abstract

Background: Older adults are at a higher risk of proximal femur fractures, particularly femoral neck and intertrochanteric fractures, often due to falls, trauma, or osteoporosis. Managing these fractures in osteoporotic bones is challenging, as they are associated with complications such as pressure sores, deep vein thrombosis, and hypostatic pneumonia. This study aimed to evaluate the outcomes of treating femoral neck fractures in elderly patients using cemented bipolar prosthesis.

Methods: A quasi-experimental study was conducted on 40 patients aged 60 to 84 years who underwent cemented bipolar hemiarthroplasty within 21 days of fracture from January 2019 to December 2019. Post-operative functional outcomes were assessed using the Harris hip score (HHS) at 3, 12, and 24 weeks, both clinically and radiologically.

Results: Of the 40 patients, 65% were female, and 52.5% had left-sided fractures. The majority (55%) experienced trivial falls. The HHS improved significantly from a mean of 43.73±6.78 at 3 weeks to 82.56±9.13 at 6 months. Garden type 3 fractures were the most common (70%). Functional outcomes were graded as good in 72.5% of patients, excellent in 17.5%, and fair in 5%, while 2.5% had a poor outcome. One patient (2.5%) died due to pulmonary embolism.

Conclusions: Cemented bipolar hemiarthroplasty in elderly patients with femoral neck fractures is a safe and effective treatment, promoting early mobilization and reducing the risk of complications such as bed sores, deep vein thrombosis, and hypostatic pneumonia.

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References

Khan AQ, Mohammad J, Qamar R, Siddiqui YS, Sabir AB, Abbas M. Cemented unipolar or modular bipolar hemiarthroplasty for femoral neck fractures in elderly patients-which is better? Int J Burns Trauma. 2021;11(6):447.

Raja BS, Gowda AK, Singh S, Ansari S, Kalia RB, Paul S. Comparison of functional outcomes and complications of cemented vs uncemented total hip arthroplasty in the elderly neck of femur fracture patients: a systematic review and meta-analysis. J Clin Orthopaed Trauma. 2022;29:101876.

Liu J, Curtis EM, Cooper C, Harvey NC. State of the art in osteoporosis risk assessment and treatment. J Endocrinological Invest 2019;42:1149-64.

Ogawa T, Jinno T, Moriwaki M, Yoshii T, Nazarian A, Fushimi K, Okawa A. Association between hospital surgical volume and complications after total hip arthroplasty in femoral neck fracture: A propensity score-matched cohort study. Injury. 2021;52(10):3002-10.

Elmenshawy AF, Salem KH. Cemented versus cementless bipolar hemiarthroplasty for femoral neck fractures in the elderly. EFORT Open Rev. 2021;6(5):380-6.

Jose RS. Study of functional outcome of unipolar and bipolar hemiarthroplasty in fracture neck of femur. Indian J Orthopaed. 2019;5(1):72-82.

Fakler JK, Pieroh P, Höch A, Roth A, Kleber C, Löffler M, Heyde CE, Zeynalova S. Predictors of long-term mortality in older patients with hip fractures managed by hemiarthroplasty: a 10-year study based on a population registry in Saxony, Germany. Patient Safety Surg. 2024;18(1):15.

Liu B, Li A, Wang J, Wang H, Zhai G, Ma H, et al. Cemented versus uncemented hemiarthroplasty for elderly patients with displaced fracture of the femoral neck: A PRISMA-compliant meta-analysis of randomized controlled trial. Medicine. 2020;99(33):e21731.

Judge A, Metcalfe D, Whitehouse MR, Parsons N, Costa M. Total hip arthroplasty versus hemiarthroplasty for intracapsular hip fracture: How should the HEALTH trial inform clinical guidelines and surgical decision-making? Bone Joint J. 2020;102(6):658-60.

Elmenshawy AF, Salem KH. Cemented versus cementless bipolar hemiarthroplasty for femoral neck fractures in the elderly. EFORT Open Rev. 2021;6(5):380-6.

Christ AB, Hornicek FJ, Fabbri N. Distal femoral replacement-Cemented or cementless? Current concepts and review of the literature. J Clin Orthopaed Trauma. 2021;19:11-6.

Biçen AÇ, Akdemir M, Turken MA, Cekok K. Long-stem Prosthesis for Intertrochanteric and Femoral Neck Fractures in the Elderly: Retrospective Comparison of Short-term Clinical Outcomes. Turk J Osteoporos. 2021;27(1):30-6.

Fu M, Shen J, Ren Z, Lv Y, Wang J, Jiang W. A systematic review and meta-analysis of cemented and uncemented bipolar hemiarthroplasty for the treatment of femoral neck fractures in elderly patients over 60 years old. Front Med. 2023;10:1085485.

Rokonuzzaman M, Al Razy MA, Afrin Z, Nahid TH, Karim MR, Sarkar MH, et al. Efficacy and Safety between Stapled Versus Hand Sewn Anastomosis in Anterior Resection for Carcinoma of Rectum. SAS J Surg. 2024;6:712-21.

Hasan M, Shahiduzzaman M, Alam MK, Al MB, Islam MS, Islam N, et al. Evaluation of Replacement Hemiarthroplasty for Femoral Component by Cemented Bipolar Prosthesis in Fracture Neck of Femur. J Bangladesh Orthopaed Society. 1993.

Digga K, Swamy A, Anzar M, Piscal T. Comparative study between functional outcomes of fracture neck of femur treated with cemented total hip replacement vs cemented bipolar hemiarthroplasty in elderly. Int J Orthopaed Sci. 2021;7(1):751-8.

Lucas A, Faizal A. Evaluation of Clinical and Radiological Outcomes in the Management of Intracapsular Fracture Neck of Femur in Elderly Treated with Cemented Bipolar Prosthesis. Cureus. 2024;16(2):e55283.

Liu K, Sheng J, Zhang H, Liu L, Tang Y, Zhu Z, et al. Risk factors for mortality after uncemented bipolar hemiarthroplasty for geriatric displaced femoral neck fracture. Orthopedics. 2021;44(4):e570-6.

Ali ME, Islam MS, Rahman MM, Rahman MM. Functional Outcome of Closed Locked Intramedullary Nailing of The Femoral Shaft Fracture. Asia Pacific J Surg Adv. 2024;1(1):4-14.

Senthilnathan A, Prabhakar R, Shankar KV, Raam BP. A comparative study of functional outcome of bipolar hemiarthroplasty versus total hip arthroplasty in fracture neck of femur in elderly patients. Int J Orthopaed. 2022;8(1):244-51.

Fenelon C, Murphy EP, Pomeroy E, Murphy RP, Curtin W, Murphy CG. Perioperative mortality after cemented or uncemented hemiarthroplasty for displaced femoral neck fractures-a systematic review and meta-analysis. J Arthroplasty. 2021;36(2):777-87.

Saravanakumar R, Maniraj SP, Barshan AD, Das S, Hasan H, Alazzam MB. Clustering big data for novel health care system. InAIP Conference Proceedings 2023;2587(1):187-91.

Tanoğlu O, Arıcan G, Özmeriç A, Şahin Ö, İltar S, Alemdaroglu B. Predictors of early mortality in geriatric patients after hemiarthroplasty for femoral neck fracture. Acta Medica Alanya. 2020;4(3):220-5.