2023 ISAKOS Biennial Congress ePoster
Functional Assessment Of Bipolar Hemiarthroplasty Versus Total Hip Replacement In Transcervical Neck Fracture Of Femur In Elderly Patients
Shubham Dakhode, MBBS, MS, DNB Orthopaedics INDIA
Ramchandra Khandelwal, MBBS MS Orthopaedics, Mumbai, Maharashtra INDIA
Prashant Gedam, MS Orthopaedics, Mumbai, Maharastra INDIA
Subith S, MBBS MS Orthopaedics, Mumbai, Maharashtra INDIA
Ketan Naik, MBBS MS Orthopaedics, Mumbai INDIA
TNMC & BYL Nair Ch. Hospital, Mumbai, Maharashtra, INDIA
FDA Status Not Applicable
Summary
Bipolar hemiarthroplasty is the preferred approach after displaced femur neck fracture in sedentary elderly population, but due to potential complications like inguinal pain and low functional outcome,Total Hip Arthroplasty should be considered as the first line of surgical management for neck of femur fracture in elderly patients since it has good functional outcome.
ePosters will be available shortly before Congress
Abstract
Purpose
Bipolar Hemiarthroplasty (BHA) and Total Hip Arthroplasty (THA) are widely accepted methods of treatment of displaced femur neck fracture in elderly patients. This study is to compare the functional outcomes of bipolar hemiarthroplasty and total hip arthroplasty in such patients.
Materials And Methods
This is a prospective study in which data of all patients with age more than 60 with trans cervical neck of femur fracture undergoing total hip arthroplasty and bipolar hemiarthroplasty is studied. Patients were randomized into two equal groups having 40 patients each. Operative time and blood loss were noted for all cases. They were followed up at 3, 6 and 12 months and compared with Modified Harris Hip Score. The results were compared between the two groups for statistical significance by a Student’s t-test. Nominal variables were tested with the chi-square test.
Results
There was moderate pain in both groups during the initial 3 months. There was a significant difference seen in pain and gait at 6 and 12 months between total hip arthroplasty and bipolar hemiarthroplasty with better scores in total hip arthroplasty group. Total hip arthroplasty group patients were observed to be able to walk without limp and support. Better functional activities were seen at 3 and 6 months in the total hip arthroplasty group. There was no difference in use of public transport and climbing stairs in both groups at 12 months. Significant difference was seen in Total Modified Harris hip score at 3, 6 and 12 months and was better in total hip arthroplasty group as compared to bipolar hemiarthroplasty group. Mean ±SD of Total Modified Harris hip score at 3, 6 and 12 months in total hip arthroplasty was 49±8.23, 67.07±9.28, 82.97±9.69 respectively for bipolar hemiarthroplasty it was 39.17±7.32, 56.2±9.8 ,75.37±13.43 respectively.
Conclusion
Bipolar hemiarthroplasty is the preferred approach after displaced femur neck fracture in sedentary elderly population, but due to potential complications like inguinal pain and low functional outcome, it has not satisfied the demand for higher quality of life due to prolonged lifespan. Total hip replacement should be considered as the first line of surgical management for neck of femur fracture in active elderly patients. It has been found to have better functional outcome, less gait disturbances and less post operative pain in patients when compared to bipolar hemiarthroplasty.