Bipolar versus fixed head hip arthroplasty for femoral neck fractures in elderly patients

ABSTRACT

Between 2002 and 2006, fifty elderly patients with displaced femoral neck fractures were treated with hip replacement at Emergency Hospital Mansoura University. Patients were randomly selected with 25 patients had either cemented or cementless bipolar prosthesis and another 25 patients had either cemented or cementless fixed head prosthesis. There were 34 females and 16 males with an average age of 63.5 years [range between 55 - 72 years]. All patients were followed up both clinically and radiologically for an average follow up period 4.4 years [range between 2-6 years]. At the final follow up, the average Harris hip score among the bipolar group was 92 points [range between 72-97 points], while the fixed head group was 84 points [range between 65 - 95 points]. Radiologically, joint space narrowing more than 2 mm was found in only 8% [2 patients] among the bipolar group, and in 28% [7 patients] of the fixed head group. Through the follow up period, total hip replacement was needed in 2 cases of the bipolar group and 7 cases of the fixed head group. Bipolar hemiarthroplasty offer a better range of movement with less pain and more stability than the fixed head hemiarthroplasty in elderly patients with displaced femoral neck fractures regardless to the cost factor