Publication:

Evaluation and compare the outcomes of patients undergoing either a unipolar or bipolar hemiarthroplasty for fractures of the femoral neck in aged patients

Background Treatment of displaced intra-capsular femoral neck fractures in older patients remains controversial. Factors such as age, fracture type, bone quality, and socio-economic status influence treatment decisions. Surgical options like hemiarthroplasty and internal fixation are considered, each with distinct outcomes and considerations. The study aimed to compare radiological and clinical outcomes, as well as functional results, between elderly patients undergoing unipolar and bipolar hemiarthroplasty for femoral neck fractures.

Methods The prospective interventional study conducted over a period of 30 months, from July 2021 to December 2023. A total of 72 patients were included in this prospective interventional study, which was conducted at the 250-bed general hospital Gopalganj and the Sheikh Sayera Khatun Medical College Hospital. Of them, 36 underwent treatment with a unipolar prosthesis and another 36 underwent treatment with a fenestrated bipolar prosthesis via a lateral approach. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 24. Results When the unipolar and bipolar groups were compared, comparable demographic distributions and mean ages (71.12 years) were found. Statistically significant differences were observed in hip scores (p value=0.019), activity on stairs (p value=0.043), and wearing shoes (p value=0.023), with the bipolar group demonstrating better outcomes in these aspects. Satisfactory outcomes were achieved by 80.55% of the unipolar group and 72.22% of the bipolar group, with 19.45% and 27.78% experiencing unsatisfactory outcomes, respectively.

Conclusions Bipolar hemiarthroplasty with a fenestrated stem may offer older patients with displaced intracapsular femoral neck fractures better functional outcomes and fewer complications compared to Austin-Moore unipolar prostheses.