Cemented versus uncemented bipolar hemiarthroplasty for femoral neck fractures in the elderly

Hailiang MENG

ABSTRACT

BACKGROUND:

Many studies have been conducted about cemented and uncemented total hip arthroplasty (THA). However, there are few reports about the differences between cemented and uncemented bipolar hemiarthroplasty in China.

OBJECTIVE:

To compare treatment effects of cemented and uncemented bipolar prostheses on fracture of femoral neck in the elderly. DESIGN, TIME AND

SETTING:

Comparative observation. The patients were selected from Department of Orthopaedics, Xi’an Red Cross Hospital from January 2004 to December 2005.

PARTICIPANTS:

131 cases of femoral neck fractures (type Garden Ⅲ and Ⅳ) were selected from Department of Orthopaedics Xi’an Red Cross Hospital, including 39 males and 92 females, aged 79 years (ranging 65-98 years); 72 cases of left hip and 59 cases of right hip.

METHODS:

The patients with various basic diseases were given corresponding treatment before surgery. The operation was performed 3 or 4 days after admission by the same operator. The patients were randomly divided into two groups, who were separately treated with cemented or uncemented prostheses. The patients were followed up for 3 years after operation and the hip function was evaluated by Harris score. MAIN OUTCOME

MEASURES:

Hip function, Harris score, mortality revision rate, revision rate and complication incidence rate.

RESULTS:

During follow-up period, 6 in cemented group and 8 in uncemented group died. After 3 month of operation, 43 patients could walk independently, 15 needed walking aid, and 5 only acted on bed in cemented group. In uncemented group, 27 patients could walk independently, and 35 needed walking aid. In hospital, 9 patients of cemented group and 15 of uncemented group had complication. After 3 years of operation, 14 cases underwent revision in cemented group due to prosthesis loosening with revision rate of 23.73%, while only 5 patients underwent revision in uncemented group, including 4 cases of prosthesis loosening and 1 of femur split with a revision rate of 23.73%. One year after operation, there was no statistically significance in Harris scores between two groups. During follow-up period, there was no difference in acetabular abrasion between two groups, but the uncemented group had a higher medullary cavity possession rate. No prosthesis dislocation, heterotopic ossification, or bone dissolving was found.

CONCLUSION:

There were no differences in hip function between cemented and uncemented bipolar hemiarthroplasty for femoral neck fractures in the elderly during follow up.