[Functional results of bipolar hemiarthroplasty in patients over 65 years of age with intracapsular hip fractures]

INTRODUCTION

Bipolar hemiarthroplasty is an alternative for the treatment of displaced femoral neck fractures in elderly patients with low functional demand and associated comorbidities. The goal was to describe functionality in patients over 65 years of age with intracapsular fractures of the hip.

MATERIAL AND METHODS

Retrospective review of patients over 65 years of age between January 2012 and May 2017. It was evaluated with the Harris Hip Score (HHS) and Oxford scale at six months and the year after surgery. Complications and mortality were documented during the first post-surgical year.

RESULTS

48 cases (12 men; 36 women), average age of 80.8 ± 7.7 years. Most common diseases: high blood pressure (77.1%), osteoporosis (37.5%), diabetes (33.3%) hypothyroidism (29.2%). The percentage of associated postoperative complications was 8.3% (four cases). The median HHS at six and 12 months was: 90.5 (DE: 77.5-96.0) and 96 (DE: 92-98), respectively. The Oxford scale was 45.5 (DE: 38.5-48.0) at six months and 47.0 (DE: 43.5-48.0) per postoperative year. 4.2% (two cases) died during the first post-surgical year and none were associated with the procedure.

DISCUSSION

HA provides good functional outcomes in patients over 65 years of age, with a low rate of complications. No mortality associated with the surgical procedure was observed in our series and in the short term.

Functional Outcome of Bipolar Prosthesis versus Total Hip Replacement in the Treatment of Femoral Neck Fracture in Elderly Patients

Introduction

The present study was performed to compare cemented total hip replacement (THR) with cemented bipolar prosthesis in the treatment of displaced fracture neck of femur in elderly patients.

Materials and Methods

This prospective study included 47 patients of greater than 60 years of age and having fracture of neck of femur, out of which 25 patients were managed by cemented bipolar prosthesis and remaining 22 were managed by cemented THR between June 2011 and June 2013. These patients were followed up post-operatively for two years, at 6, 12 and 24 months, for functional analysis using Modified Harris Hip Score.

Results

Modified Harris Hip Score was significantly higher in the THR group as compared to the bipolar prosthesis group at 6, 12 and 24 months post-operatively. Pain was almost similar in both the groups at all follow-up periods. Gait and range of motion was significantly higher in THR group as compared to bipolar prosthesis group at all-time point intervals.

Conclusion

Cemented THR is a better option as compared to cemented bipolar prosthesis based on our short term functional outcome for the management of fracture of neck of femur in elderly patients.