Comparison of functional outcome between Bipolar Hemiarthroplasty and total Hip Arthroplasty for displaced femoral neck fractures in elderly patients

Abstract

Objectives: The intention of this study to compare functional outcomes between Total Hip Arthroplasty and Bipolar Hemi Arthroplasty for displaced femoral neck fracture after 3 months and 1 year from injury in elderly patients. Methods: Prospectively 43 patients were enrolled in this study, ages more than 60, twenty-four of them managed by Total Hip Arthroplasty, and 19 were managed by Bipolar Hemi Arthroplasty. These patients were followed up postoperatively for one year, at (3 and 12 months), to compare functional outcomes using Haris Hip Score. Results: Duration of operation was significantly higher in Total Hip Arthroplasty (98.54 min) versus (62.63 min) in the Bipolar Hemi Arthroplasty group, and intra-operative blood loss also considerably higher in Total Hip Arthroplasty (322.5 ml) than Bipolar Hemi Arthroplasty (178.42 ml). Regarding complications, there is no difference between the two groups; however, the incidence of mortality higher in the Bipolar Hemi Arthroplasty population. Average Haris Hip Score, pain and the motion were significantly better after three months and one-year follow-up in the Total Hip Arthroplasty group. The function was nearly the same at both groups after three months but after one-year of follow-up function significantly better (p-value <0.5) in the Total Hip Arthroplasty patients.Conclusion: Total Hip Arthroplasty provides better functional outcomes after three months and one year of follow-up than Bipolar Hemi Arthroplasty when used to manage femoral neck fracture for active old age patients. Bipolar Hemi Arthroplasty may be suitable for older inactive patients with narrow life expectancy with multiple comorbiditie