Journal of Orthopedics and Joint Surgery

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VOLUME 4 , ISSUE 1 ( January-June, 2022 ) > List of Articles

Original Article

Functional Outcome of Bipolar Hemiarthroplasty for Proximal Femoral Neck Fractures in Elderly: A Prospective Study

Vijayanand Ramasamy, Rajkumar Nallan

Citation Information : Ramasamy V, Nallan R. Functional Outcome of Bipolar Hemiarthroplasty for Proximal Femoral Neck Fractures in Elderly: A Prospective Study. 2022; 4 (1):22-25.

DOI: 10.5005/jp-journals-10079-1053

License: CC BY-NC 4.0

Published Online: 28-01-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim and background: Hip fractures are the most frequently seen injuries by orthopedic surgeons and are particularly prevailing in the geriatric community. This study was performed to evaluate the efficacy of the bipolar hemiarthroplasty among elderly patients with a proximal femoral neck fracture. Materials and methods: This was a prospective study undertaken at the Department of Orthopedic Surgery at a tertiary care institute from January 2014 to December 2015. The patients were selected based on the convenience sampling (Judgment sampling) method. Bipolar hemiarthroplasty was performed. The majority had cemented implants, with three having uncemented. Functional outcome was assessed periodically at 6 weeks, 3 months, 6 months, and 1 year using modified Harris hip scoring system using coGuide for statistical analysis and p value set at 0.05. Results: A total of 43 patients >50 years of age with 23 (54.5%) males and 20 (45.5%) females, among which 39 (90.69%) with fractured neck of femur and 4 (9.31%) with trochanteric fracture were studied. Forty (93%) had cemented implants. Harris hips ROM score 5 was noted in 50% of the participants, scores 4 and 3 in 42.5 and 7.5%, respectively. Excellent functional score was noted in 16 (40%), good in 18 (45%), satisfactory in 3 (7.5%), and 3 (7.5%) had poor score. Only two (5%) participants had radiolucent zone >2 mm and one (2.5%) had subsidence of prosthesis >5 mm. Conclusion: Cemented bipolar hemiarthroplasty is present in mobile geriatric patients above 50 years of age with a proximal femoral neck fracture. Clinical significance: A bipolar hemiarthroplasty is a reliable option in treating fracture neck of femur in the elderly with several comorbidities. All the participants had a sufficient functional outcome in regular daily activity, less hospital stay, residual pain, postoperative functionality, and fewer postoperative complications. It can be used in day-to-day clinical practice.


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  1. Lehtonen EJI, Stibolt Jr RD, Smith W, et al. Trends in the surgical treatment of femoral neck fractures in the elderly. Einstein 2018;16(3):eAO4351. DOI: 10.1590/s1679–45082018ao4351.
  2. Parker M, Johansen A. Hip fracture. BMJ 2006;333((7557)):27–30. DOI: 10.1136/bmj.333.7557.27
  3. Kristensen TB, Dybvik E, Kristoffersen M, et al. Cemented or uncemented hemiarthroplasty for femoral neck fracture? data from the norwegian hip fracture register. Clin Orthop Relat Res 2020;478(1):90–100. DOI: 10.1097/corr.0000000000000826
  4. Reddy GR, Prasad PN. Efficacy of bipolar hemiarthroplasty in the elderly people: a study in a tertiary care centre. Int J Res Orthop 2017;3(3):396. DOI: 10.18203/issn.2455–4510.IntJResOrthop20171573
  5. Iorio R, Schwartz B, Macaulay W, et al. Surgical treatment of displaced femoral neck fractures in the elderly: a survey of the American Association of Hip and Knee Surgeons. J Arthroplast 2006;21(8):1124– 1133. DOI: 10.1016/j.arth.2005.12.008
  6. Bhandari M, Devereaux PJ, Tornetta P, et al. Operative management of displaced femoral neck fractures in elderly patients. An international survey. J Bone Jt Surg Am 2005;87(9):2122–2130. DOI: 10.2106/jbjs.e.00535
  7. Bhattacharyya T, Koval KJ. Unipolar versus bipolar hemiarthroplasty for femoral neck fractures: is there a difference?J Orthop Trauma 2009;23(6):426–427. DOI: 10.1097/BOT.0b013e3181adb057
  8. Gilbert MS, Capozzi J. Unipolar or bipolar prosthesis for the displaced intracapsular hip fracture? an unanswered question. Clin Orthop Relat Res 1998(353):81–85. DOI: 10.1097/00003086-199808000-00010
  9. Choy WS, Ahn JH, Ko JH, et al. Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients. Clin Orthop Surg 2010;2(4):221–226. DOI: 10.4055/cios.2010.2.4.221
  10. Vala P, Shah R, Gandhi T, et al. Outcomes of primary bipolar hemiarthroplasty in the management of unstable inter-trochanteric fracture of femur among elderly. IntJ Orthop 2019;5(2):739–743. DOI: 10.22271/ortho.2019.v5.i2k.81
  11. BDSS Corp. Released 2020. coGuide Statistics software, Version 1.0, India: BDSS corp.
  12. Wathne RA, Koval KJ, Aharonoff GB, et al. Modular unipolar versus bipolar prosthesis: a prospective evaluation of functional outcome after femoral neck fracture. J Orthop Trauma 1995;9(4):298–302. DOI: 10.1097/00005131-199509040-00005
  13. Saoudy EE, Salama AM. Bipolar hemiarthroplasty for the treatment of unstable trochanteric fracture femur in the elderly. Egypt Orthop J 2016;51(4):313
  14. Patil V, Nandi SS, Naik S, et al. Functional outcome of unstable comminuted intertrochanteric fractures in elderly treated with primary bipolar hemiarthroplasty. IntJ Orthop 2019;5(1):59–62. DOI: 10.22271/ortho.2019.v5.i1b.13
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