Surgical management of intracapsular fracture neck femur by hemiarthroplasty between uncemented bipolar prosthesis and Austin Moore’s prosthesis: a comparative study in elderly population

Background: Intracapsular femoral neck fractures are common in elderly population after a simple fall. To avoid the drawbacks of internal fixation and for the early mobilization, hemiarthroplasty is performed in elderly. The aim of this study is to compare the outcome AMP with uncemented bipolar prosthesis in geriatric patients.Methods: 51 patients above 60 years and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either AMP (Austin Moore prosthesis) or bipolar hemiarthroplasty, in the Department of Orthopaedics, Sri Siddhartha medical college, Tumkur between April 2014 and May 2017. The patients were summoned at 6 weeks, 12 weeks, 6 months and 1 year. Functional outcome was assessed and compared with modified Harris hip score and radiological parameters.Results: The mean Harris hip score in bipolar and AMP group was 86.31±12.1 and 79.86±15.42, respectively (p=0.182). The range of motion was 204.52±28.2 and 183.62±36 (p=0.014) respectively. Functional activities like use of public transport and ability to wear shoe or socks was better with bipolar group. Incidence of complications like painful hip, posterior dislocation, periprosthetic fracture and acetabular erosion was encountered in AMP group.Conclusions: The use of uncemented bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly was associated with better mean Harris hip score and incidence of complications was limited. Hence, bipolar would be a better option in elderly patients with fracture neck of femur.

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Treatment of Displaced Femoral Neck Fractures: Unipolar Hemiarthroplasty Versus Bipolar Hemiarthroplasty

KYAMC Journal ◽

10.3329/kyamcj.v8i1.33866 ◽

2017 ◽

Vol 8 (1) ◽

pp. 10-14

Author(s):

Md Ashraful Islam ◽

Md Abdur Rashid ◽

Md Rafiqul Islam ◽

Md Masudar Rahman ◽

Md Asmaul Hossain Khan ◽

...

Keyword(s):

Femoral Neck ◽

Early Mobilization ◽

The Elderly ◽

Femoral Neck Fractures ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Medical College ◽

Bipolar Group ◽

Displaced Femoral Neck Fractures ◽

Displaced Fracture

Background: Femoral neck fractures are common in the elderly population. To avoid the poor outcome of internal fixation and for early mobilization, hemiarthroplasty is performed. However, there is inadequate evidence to support the choice between unipolar or bipolar hemiarthroplasty.Objectives: The aim of this study was to compare the outcome of unipolar with the bipolar prosthesis in geriatric patients.Methods: Forty-one patients above 60 years of age and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either unipolar or bipolar hemiarthroplasty, in the Department of Orthopaedics at Khwaja Yunus Ali Medical College and Hospital, Enayetpur, Sirajgonj, Bangladesh in between December 2014 and February 2017. Functional outcome was assessed and compared using Harris hip score and radiological parameters with a follow-up of one year.Results: The two groups of patients with mean age of 67.3 in bipolar group and 75.6 in unipolar group did not differ in their pre-injury characteristics and perioperative parameters. The mean Harris hip score in bipolar and unipolar groups was 86.18±12.18 and 79.79±15.55, respectively (p=0.183); range of motion was 210.63±28.39 and 181.58±37(p=0.015) with bipolar and unipolar groups, respectively. Functional activities were better in the bipolar group. Complications like painful hip, posterior dislocation, periprosthetic fracture and acetabular erosion were encountered in unipolar prostheses.Conclusion: The use of bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly was associated with better mean Harris hip score and incidence of complications was limited. Hence, bipolar would be a better option in elderly patients with fracture neck of femur.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 10-14

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A study of prospective analysis of unipolar versus bipolar hemiarthroplasty of hip joint in patients with fracture neck of femur

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211621 ◽

2021 ◽

Vol 7 (3) ◽

pp. 629

Author(s):

Raja X. ◽

Arjun Sarvesh ◽

Karthikeyen M. ◽

A. E. Manoharan

Keyword(s):

Femoral Neck ◽

Weight Bearing ◽

Femoral Neck Fractures ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Early Weight Bearing ◽

Group I ◽

Significant Difference ◽

Group Ii

Background: Femoral neck fractures occur most commonly in elderly females and are a major cause of morbidity and mortality in this age group and require immediate and appropriate management. Aim of the study was to compare the functional outcome of unipolar Austin Moore's prosthesis (AMP) hemiarthroplasty (HA) and bipolar (BHA) HA with femoral neck fractures using Harris hip score system.Methods: The study was conducted on 60 patients aged above 50 years with fractured neck of femur admitted in Vinayaka missions Kirupananda Variyar medical college and hospital from August 2017 to August 2019. Patients with femoral neck fracture were allocated randomly to have 30 cases of AMP.Results: Out of the 60 cases, the patients in the bipolar (nonmodular) HA group II showed better functional outcomes compared to unipolar (AMP) HA group I after six months follow-ups. At 12 months of follow-up, there was no significant difference between group I (AMP) and group II (BHA).Conclusions: Our study demonstrates, hemiarthroplasty of the hip for femoral neck fractures is a good option in elderly patients. The mortality and morbidity are not high, the operative procedure is simple, complications are less disabling, early weight-bearing and functional results are satisfactory and second surgery are less frequently required.

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Functional Outcome of Intracapsular Femoral Neck Fractures Treated by Bipolar Hemiarthroplasty

10.53350/pjmhs21155988 ◽

2021 ◽

Vol 15 (5) ◽

pp. 988-991

Author(s):

Zamir Hussain Tunioi ◽

Rizwan Ali Jhatiyal ◽

M Azeem Akhund ◽

M Kashif Abbasi ◽

L Das Maheshwari ◽

...

Keyword(s):

Femoral Neck ◽

Functional Outcome ◽

Femoral Neck Fractures ◽

University Hospital ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Cross Sectional ◽

Average Hospital

Aim: To evaluate the functional outcome of bipolar hemiarthroplasty in intracapsular fracture neck of femur. Study design: Descriptive cross sectional study. Place and duration of study: Department of Orthopaedic Surgery & Traumatology, Peoples Medical University Hospital, Shaheed Benazir Abad from 1st December 2017 to 31st December 2020. Methodology: Sixty six cases of intracapsular femoral neck fractures with age ranging from 50 year to 75 year of either gender who were ambulatory before injury were included; while basicervical, younger than 50 years, with neuromuscular disorder, unfit for surgery, open fracture, bilateral injuries, osteoarthritis of hip, Rheumatoid, Gouty, pathological fractures, bedridden & who did not give consent for study, were excluded from the study. Functional outcome assessed by Harris hip score & data analyzed by SPSS version 23. Results: Twenty six (59.09%) were male and 40 (40.91%) were female with mean age of 64.3±7.77 year. Average time from injury to hospital arrival was 14.7±6.8 hours. Average time from hospitalization to surgery was 4.67±2.23 days. Average time of surgery was 55.67±9.9 minutes. Average hospital stay was 9.7±4.3 days. The average time of follow-up was 18.45±7.63 months. Conclusion: Bipolar implant is safe, effective, reliable, stable and cost effective implant for intracpsular fracture of femoral neck in elderly populace. The 66.66% of patients have satisfactory Harris hip score in follow up duration of 18.45±7.63 months. Keywords: Functional, Outcome, Femoral neck fractures, FNF, Bipolar, Hemiarthroplasty, HHS

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Prospective study of the functional outcome of uncemented bipolar hemiarhroplasty in displaced fracture neck of femur in elderly

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20201736 ◽

2020 ◽

Vol 6 (3) ◽

pp. 567

Author(s):

Radhakrishna A. Mallegowda ◽

Channappa T. Seetharam ◽

Shivanand Sundaram ◽

Jayaram B. Siddegowda ◽

Veeresh Nijalingappa

Keyword(s):

Functional Outcome ◽

Early Mobilization ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Bipolar Prosthesis ◽

Fracture Neck Of Femur ◽

Excess Morbidity ◽

Predominantly Female ◽

Displaced Fracture

Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity, mortality and loss of independence. To avoid the drawbacks of internal fixation and for early mobilization, hemiarthroplasty is performed in elderly. The bipolar prosthesis was developed to overcome the shortcomings of the unipolar fixed-head prosthesis. An additional site of motion would be expected to decrease the amount of loosening, dislocation, and head migration. The aim of the study is to assess the functional outcome of the patients with fracture neck of femur treated with bipolar hemiarthroplasty.Methods: In this study, 20 patients above the age of 60 years with acute displaced fracture neck of femur underwent hemireplacement arthroplasty with bipolar prosthesis in Department of Orthopaedics, KIMS, Bangalore. The patients were followed up on 6th, 12th, 18th, 24th week post operatively. Functional outcome was assessed with Harris hip score.Results: In our study, mean average age was 72.3 years with predominantly female patients with 75% of the patients with left sided fracture. 95% of the patients had slight or no pain, 85% of patients had slight or no limp. 50% of the patients could walk without support, 65% of the patients could walk a distance of 6 blocks or more. Average Harris hip score was 82%.Conclusions: These results suggest functional outcome following bipolar hemiarthroplasty is good. Early mobilisation, pain free hip and with good level of activity is obtained following bipolar hemiarthroplasty.

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Cementless bipolar hemiarthroplasty for displaced fracture neck of femur with modular hydroxyapatite coated stem in elderly with cardiopulmonary co-morbidities

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171807 ◽

2017 ◽

Vol 5 (5) ◽

pp. 1862

Author(s):

Towseef Ahmad Bhat ◽

Zameer Ali ◽

Amara Gulzar ◽

Furqaan Mirza

Keyword(s):

Femoral Neck ◽

Elderly Patients ◽

Femoral Neck Fractures ◽

Harris Hip Score ◽

Anterolateral Approach ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Cardiopulmonary Complications

Background: Bipolar hemiarthroplasty is one of the common procedures done for fracture neck of femur in elderly. Debate about Cemented or cementless is still on. Cementing increases perioperative mortality by causing significant hemodynamic changes or embolization. Patients with cardiopulmonary complications are at higher risk of cementing complications. We report our series of 31 cases of fracture neck of femur with cardiopulmonary diseases operated over 2 years with modular cementless bipolar hemiarthroplasty.Methods: 31 elderly patients with cardiopulmonary co-morbidities (age=75 to 97 years) with displaced femoral neck fractures were operated between January 2011 to December 2013. Cementless bipolar hemiarthroplasty using hydroxyapatite coated stem was done by single surgeon using same implant in all the patients through anterolateral approach. Clinical and radiological follow-up was done with mean follow up of 54 months (36-72 months).Results: Total 31 cases with cardiopulmonary comorbidities were operated. The average follow up was 54 months. No intraoperative mortality was seen. 3 patients had splitting of femur during canal preparation. 1 patient died due to cardiac arrest in the post-operative period. 1 patient had surgical site infection. 3 patients had hemodynamic abnormalities and 1 patient had significant limb length discripency (1.5 cm). 2 patients died in the follow up because of comorbidities. 27 patients reached to pre-injury status with average harris hip score of 86 at final follow up.Conclusions: Cementless bipolar hemiarthroplasty with hydroxyapatite coated stem is a good option for femoral neck fractures in elderly patients with cardiopulmonary complications without risking the harmful effects of cementing.

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