Bipolar Hemiarthroplasty for Femoral Neck Fractures in the Elderly

Abstract

(Fig. 1) REFERENCESPurpose: To evaluate outcomes after treatment of femoral neck fractures in patients 75 years of age or older. Materials and Methods:We reviewed the records of 186 patients 75 years of age or older who underwent bipolar hemiarthroplasty between March 1995 and March 2005 and who were followed for more than two years after surgery. The mean patient age was 84.3 years (range 75~99 years). Forty-eight patients were men, and 138 patients were women. The mean follow-up period was 68.4 months (range 24~113 months). We evaluated the results by analyzing modified Harris hip score, walking ability, activities of daily living, complications, osteoporosis, and radiologic findings. Results:The mean Harris hip score was 89.2 (range 74~95). Walking ability was recovered in 87.6% of cases (163 cases), and activities of daily living were achieved in 85.4% of cases (159 cases). There were 3 cases of acetabular erosion or proximal migration and 3 cases of aseptic loosening in a cemented stem. Thigh pain occurred in 8 cemented stems and in 4 cementless stems. Conclusion:We believe bipolar hemiarthroplasty is a useful treatment in elderly patients with femoral neck fractures and severe osteoporosis, especially in view of the stable and rigid fixation of the femoral stem, early ambulation, and the low rate of complications and death, even if the operation is technically very difficult.