Hemiarthroplasty for intra-capsular fracture neck of femur in elderly patients: a prospective observational study


  • Abhishek Kalantri Department of Orthopedics, Index Medical College Hospital & Research Centre, Index City, Indore, Madhya Pradesh, India
  • Sunil Barod Department of Orthopedics, Index Medical College Hospital & Research Centre, Index City, Indore, Madhya Pradesh, India
  • Dilip Kothari Department of General Surgery, Index Medical College Hospital & Research Centre, Index City, Indore, Madhya Pradesh, India
  • Archana Kothari Department of General Surgery, Amaltas Institute of Medical Sciences, Village Bangar, Dewas - Ujjain Highway, Dewas, Madhya Pradesh, India
  • Ashok Nagla Department of Orthopedics, Index Medical College Hospital & Research Centre, Index City, Indore, Madhya Pradesh, India
  • Pawan Bhambani Department of Pathology, Index Medical College Hospital & Research Centre, Index City, Indore, Madhya Pradesh, India




Fracture neck of femur, Intra-capsular, Hemiarthroplasty, Elderly, Harris hip score, Outcome


Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity and mortality, and loss of independence. This study was aimed at evaluating the outcome of hemiarthroplasty, by assessing the quality of life and degree of function in the operated limb.

Methods: Out of 30 patients treated in this manner, all cases were available for follow-up period of 6 months. Patients of age 60 years and above, diagnosed with fracture neck of femur, were included in the study.

Results: Majority of patients belongs to age group 60-69 years was 56.7% Females were more common 56.7% than males in the present study. About 13.3% patients sustained the injury due to a fall from a height and 23.3% due to a road traffic accident. About 20 patients (60%) had a stay of less than 20 days in hospital. In our study Harris hip score, at end of six month ranged from 35 to 94.6. At final 6 months follow-up by Harris hip scoring system, 53.33% had excellent result, 33.3% had good results, 16.67% had fair results and 6.67% had poor results.

Conclusions: We conclude that hemiarthroplasty for fracture neck of femur is a good option in elderly patients. The mortality and morbidity are not high, operative procedure is simple, complications are less disabling. Early functional results are satisfactory.


Miyamoto RG, Kaplan KM, Levine BR, Egol KA, Zuckerman JD. Surgical management of hip fractures: an evidence-based review of the literature. I: femoral neck fractures. J Am Acad Orthop Surg. 2008;16:596-607.

Ossendorf C, Scheyerer MJ, Wanner GA, Simmen HP, Werner CM. Treatment of femoral neck fractures in elderly patients over 60 years of age - which is the ideal modality of primary joint replacement? Patient Saf Surg. 2010;4(1):16.

Hopley C, Stengel D, Ekkernkamp A, Wich M. Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ. 2010;340:2332.

Benterud JG, Kok WL, Alho A. Primary and secondary Charnley-Hastings hemiarthroplasty in displaced femoral neck fractures and their sequelae. Ann Chir Gynaecol. 1996;85:72-6.

Bochner RM, Pellicci PM, Lyden JP. Bipolar hemiarthroplasty for fracture of the femoral neck. Clinical review with special emphasis on prosthetic motion. J Bone Joint Surg Am. 1988;70:1001-10.

Dixon S, Bannister G. Cemented bipolar hemiarthroplasty for displaced intracapsular fracture in the mobile active elderly patient. Injury. 2004;35:152-6.

Fang CH, Lee TS, Hsu KC: Clinical experience of hemiarthroplasty with Bateman bipolar endoprosthesis. Gaoxiong Yi Xue Ke Xue Za Zhi. 1990;6:268-75.

Overgaard S, Jensen TT, Bonde G, Mossing NB. The uncemented bipolar hemiarthroplasty for displaced femoral neck fractures. 6-year follow-up of 171 cases. Acta Orthop Scand. 1991;62:115-20.

LaBelle LW, Colwill JC, Swanson AB. Bateman bipolar hip arthroplasty for femoral neck fractures. A five- to ten-year follow-up study. Clin Orthop Relat Res. 1990;(251):20-5.

Maini PS, Talwar N, Nijhawan VK, Dhawan M. Results of cemented bipolar hemiarthroplasty for fracture of the femoral neck - 10 year study. Indian J Ortho. 2006;40(3):154-6.

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 Amer. 2005;87:2122-30.

Gjertsen JE, Vinje T, Lie SA, Engesaeter LB, Havelin LI, Furnes O, et al. Patient satisfaction, pain, and quality of life 4 months after displaced femoral neck fractures: a comparison of 663 fractures treated with internal fi xation and 906 with bipolar hemiarthroplasty reported to the Norwegian Hip Fracture Register. Acta Orthop. 2008;79:594-601.

Norrish AR, Rao J, Parker MJ. Prosthesis survivorship and clinical outcome of the Austin Moore hemiarthroplasty: An 8-year mean follow-up of a consecutive series of 500 patients. Injury. 2006;37:734-9.

Maruthi CV, Shivanna. Management of fracture neck of femur in elderly by hemiarthroplasty: A study. Indian J Orthop Surg. 2016;2(2):170-80.

Raghvendra TS, Reddy BSJ, Jayaram J. Management of Fracture Neck of Femur with Cemented Bipolar Prosthesis. Indian J Clin Prac. 2014;24(9):867-71.

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 Ortho J. 2010;4(1):26-31.

Moore AT, Bohlman HR. Metal hip joint: a case report. JBJS. 1943;25:688-92.

Carnesale PG, Anderson LD. Primary prosthetic replacement for femoral neck fractures. Arch Surg. 1975;110:27-9.

Arwade DJ. A review of internal fixation and prosthetic replacement for fresh fractures of the femoral neck. Clini Orthop India. 1987;1:77-82.

Kenzora JE, Magaziner J, Hudson J, Hebel JR, Young Y, Hawkes W, et al. Outcome after hemiarthroplasty for femoral neck fractures in the elderly. Clin Orthop Relat Res. 1998;348:51-8.

D'acry J, Devas M. Treatment of fractures of the femoral neck by replacement with the thompson prosthesis. JBJS. 1976;58:279-86.

Mukherjee DL, Puri HC. Early hemiarthroplasty for fresh fractures of the neck of the femur in geriatric patients. Indian J Surg. 1986;48:77-80.

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.

Koval KJ, Zuckerman JD. Functional recovery after fracture of the hip. J Bone Joint Surg Am. 1994;76(5):751-8.

Barnes R. Problems in the treatment of femoral neck ractures. Proc R Soc Med. 1970;63(11):1119-20.

Blomfeldt R, Tornkvist H, Eriksson K, Soderqvist A, Ponzer S, Tidermark J. A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. J Bone Joint Surg Br. 2007;89:160-5.

Narayan KK, George T. Functional outcome of fracture neck of femur treated with total hip replacement versus bipolar arthroplasty in a South Asian population. Arch Orthop Trauma Surg. 2006;126:545-8.

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 Am. 1969;51:737-55.






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