Results Of Fracture Neck Of Femur Treated With Modular Bipolar Hemiarthroplasty In Elderly-Our Experience In 70 Cases
Journal Title: International Journal of Orthopaedics Traumatology & Surgical Sciences - Year 2016, Vol 2, Issue 0
Abstract
Aim of the study: The treatment of fractures neck of femur has evolved over a period of time with osteosynthesis to prosthetic implantation. Early mobility, immediate pain reliefs are the major advantages of the bipolar hemiarthroplasty in the elderly population. Materials and Methods: This was a retrospective analysis of prospectively collected data of 70 consecutive patients with displaced intracapsular fracture neck of femur in elderly at a single institute. A standard posterior approach was used; cementless modular bipolar instrumentation was performed. All patients were followed up at one year, two years and four years. The functional assessment was done with Modified Harris Hip Score along with radiological assessments. Results A total of 70 patients were included in the study, five were excluded due of loss of follow up. The mean age of patients was 64, with female preponderance (M: F; 21:49).Thirty two patients were Garden stage 3, 38 patients were stage 4. The mean duration of surgery was 130 minutes and average blood loss was 180-200ml.One patient (1.4%) had intra-operative fracture of greater trochanter and two (2.8%) had superficial infection. The mean MHHS at the end of one year was 78.65, 21 patients were available at two year follow up with mean MHHS of 77.5 whereas 9 patients were available for four year follow-up with mean score of 74.5. One patient (1.4%) had stem loosening at the end of one year, revised with long stem prosthesis. Conclusion Hemiarthroplasty using cementless Modular Bipolar prosthesis for fractures of the femoral neck in elderly provides freedom from pain, better range of movement and more rapid return to unassisted activity with an acceptable complication rate. Though conventionally done in an uncemented fashion, providing a good primary anchorage, especially in the osteoporotic femur is of paramount importance. The long term results using Modular bipolar prosthesis needs further study for a longer period in a larger sample with a direct comparison between the cemented versus uncemented groups. Clinical significance: The treatment of these commonly found fractures with modular bipolar Hemiarthroplasty has given promising results. The mid-termoutcome from this study provides evidence that this is suitable treatment option in displaced intracapsular fracture neck of femur in elderly.
Authors and Affiliations
Ravi m Daddimani, Vishwanath M PAtil, Chidendra M shettar, Vinay Bableshwar, Srinath K Madhavmurthy
Keywords
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