Comparison of Bipolar Hemiarthroplasty and Total Hip Arthroplasty using Large Heads in Patients with Femoral Neck Fractures / 대한정형외과학회잡지

PURPOSE: To compare the short-term clinical outcomes of total hip arthroplasty (THA) with a large diameter femoral head (36 mm) and bipolar hemiarthroplasty (BA) in physiologically active elderly patients with femoral neck fractures. MATERIALS AND METHODS: This non-concurrent clinical trial included 169 patients with femoral neck fractures, who had been treated with prosthetic replacement from February 2004 and June 2007. Eighty-nine and 80 cases underwent BA and THA, respectively. The mean follow-up period was 36 months (18-52). The clinical outcomes were analyzed, and the latest follow-up radiographs were assessed to determine the number of complications. RESULTS: The mean operation time was longer in the THA group. The pain, mobility, and walking ability factors were better in the THA group than in the BA group. There was no limitation in the range of motion in the early post-operative period and no dislocations were encountered in either group. CONCLUSION: THA with a large diameter femoral head is recommended for the management of patients with femoral neck fractures.

Early Results after the Treatment with Total Hip Arthroplasty with Larger Diameter Femoral Head versus Bipolar Arthroplasty in Patients with Femoral Neck Fractures

PURPOSE: To study the short-term clinical outcomes of THA with a large diameter femoral head (36 mm) and BA in physiologically active elderly patients with displaced femoral neck fractures MATERIALS AND METHODS: This non-concurrent clinical trial included 40 patients with displaced femoral neck fractures, who had been treated with prosthetic replacement from February 2004 and December 2004. Twenty patients underwent either THA or BA. The mean follow-up period was 18 months(12~26). The clinical outcome was analyzed, and the latest follow-up radiographs were assessed to determine the number of complications, such as osteolysis, loosening, fracture, dislocation, etc. RESULTS: The clinical and functional results were better in the THA group than in the BA group. The mean operation time was significantly shorter in the BA group than in the THA group. The mean intra-operative blood loss was similar in the two groups. Despite there being no limitation of the range of motion in the early post-operative period, there was no dislocation encountered in either group. CONCLUSION: A THA with a large diameter femoral head is recommended for the management of patients with femoral neck fractures because THA produces a better result than BA.