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

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. 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.