J Korean Fract Soc.  2008 Jan;21(1):8-12. 10.12671/jkfs.2008.21.1.8.

Bipolar Hemiarthroplasty for the Femoral Neck Fractures in Elderly Patients

• Jeong WK
• Park SW
• Lee SH
• Park JH
• Lee SH
• Kang JH
• Choi GW
• Noh W

• KMID: 1480957
• DOI: http://doi.org/10.12671/jkfs.2008.21.1.8

Abstract

PURPOSE: To evaluate the clinical results of bipolar hemiarthroplasty in elderly patients more than 65 years of age with a femoral neck fracture.
MATERIALS AND METHODS
Forty-six bipolar hemiarthroplasties in 43 patients more than 65 years of age which could be followed more than 3 years were included in this study. The clinical outcomes were evaluated using Harris hip score, pain score and support score. The radiological results were analyzed by femoral stem loosening and bipolar cup migration.
RESULTS
The average Harris hip score was 88.7 (62~96) points. An excellent score was recorded in 34 cases, good in 7 cases, fair in 3 cases and poor in 2 cases. The average pain score was 39.3 points and there were no pain in 20 cases, slight pain in 17 cases, mild pain in 6 cases and moderate pain in 2 cases. The average support score was 9.6 points and 32 patients could walk without the use of any assistive devices. Two cases were converted to total hip arthroplasty due to femoral stem loosening with or without bipolar cup migration.
CONCLUSION
For the early ambulation and functional recovery of elderly patients with femoral neck fracture, bipolar hemiarthroplasty was considered as one of recommendable methods.

Keyword

Hip; Femoral neck fracture; Bipolar hemiarthroplasty; Elderly patients

MeSH Terms

Aged
Arthroplasty
Early Ambulation
Femoral Neck Fractures
Femur Neck
Hemiarthroplasty
Hip
Humans
Self-Help Devices

Reference

1. Bateman JE. Single-assembly total hip prosthesis--preliminary report. 1974. Clin Orthop Relat Res. 1990; 251:3–6.

2. Bezwada HP, Shah AR, Harding SH, Baker J, Johanson NA, Mont MA. Cementless bipolar hemiarthroplasty for displaced femoral neck fractures in the elderly. J Arthroplasty. 2004; 19:7 Suppl 2. 73–77.

3. Callaghan J, Rosenberg A, Rubash H. The adult hip. 3rd ed. Philadelphia: Lippincott-Raven publisher;1998. p. 1221–1228.

4. Coleman SH, Bansal M, Cornell CN, Sculco TP. Failure of bipolar hemiarthroplasty: a retrospective review of 31 consecutive bipolar prostheses converted to total hip arthroplasty. Am J Orthop. 2001; 30:313–319.

5. Crossman PT, Khan RJ, MacDowell A, Gardner AC, Reddy NS, Keene GS. A survey of the treatment of displaced intracapsular femoral neck fractures in the UK. Injury. 2002; 33:383–386.

6. D'Arcy J, Devas M. Treatment of fractures of the femoral neck by replacement with the Thompson prosthesis. J Bone Joint Surg Br. 1976; 58:279–286.

7. Davison JN, Calder SJ, Anderson GH, et al. Treatment for displaced intracapsular fracture of the proximal femur. A prospective, randomized trial in patients aged 65 to 79 years. J Bone Joint Surg Br. 2001; 83:206–212.

8. Drinker H, Murray WR. The universal proximal femoral endoprosthesis. A short-term comparison with conventional hemiarthroplasty. J Bone Joint Surg Am. 1979; 61:1167–1174.

9. Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br. 1961; 43:647–663.

10. Giliberty RP. A new concept of a bipolar endoprosthesis. Orthop Rev. 1974; 3:40–45.

11. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fracture: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969; 51:737–755.

12. Iorio R, Schwartz B, Macaulay W, Teeney SM, Healy WL, York S. Surgical treatment of displaced femoral neck fractures in the elderly: a survey of the American Association of Hip and Knee Surgeons. J Arthroplasty. 2006; 21:1124–1133.

13. Keating JF, Grant A, Masson M, Scott NW, Forbes JF. Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty. Treatment of displaced intracapsular hip fractures in healthy older patients. J Bone Joint Surg Am. 2006; 88:249–260.

14. Kenzora JE, Magaziner J, Hudson J. Outcome after hemiarthroplasty for femoral neck fractures in the elderly. Clin Orthop Relat Res. 1998; 348:51–58.

15. Lo WH, Chen WM, Huang CK, Chen TH, Chiu FY, Chen CM. Bateman bipolar hemiarthroplasty for displaced intracapsular femoral neck fractures. Uncemented versus cemented. Clin Orthop Relat Res. 1994; 302:75–82.

16. Melton LJ 3rd. Hip fractures: a worldwide problem today and tomorrow. Bone. 1993; 14:Suppl 1. S1–S8.

17. Moore AT. The self-locking metal hip prosthesis. J Bone Joint Surg Am. 1957; 39:811–827.

18. Park SW, Han SB, Lee SH, Chung WK, Wang SY. The effectiveness of bone scintigraphy of femur neck fracture. J Korean Soc Fract. 2001; 14:323–330.

19. Park SW, Hur CY, Baek JR, Park SJ. Factors predisposing to complications after internal fixation of femoral neck fracture. J Korean Soc Fract. 2003; 16:441–446.

20. Park SY, Yang IH, Kim SH, Han CD. Cementless bipolar hemiarthroplasty for femoral neck fracture in patients more than eighty years old. J Korean Orthop Assoc. 2006; 41:680–686.

21. Parker MJ. The management of intracapsular fractures of the proximal femur. J Bone Joint Surg Br. 2000; 82:937–941.

22. Parker MJ, Khan RJ, Crawford J, Pryor GA. Hemiarthroplasty versus internal fixation for displaced intracapsular hip fractures in the elderly. A randomised trial of 455 patients. J Bone Joint Surg Br. 2002; 84:1150–1155.

23. Phillips TW. Thompson hemiarthroplasty and acetabular erosion. J Bone Joint Surg Am. 1989; 71:913–917.

24. Raaymakers EL. Fractures of the femoral neck: a review and personal statement. Acta Chir Orthop Traumatol Cech. 2006; 73:45–59.

25. Rogmark C, Carlsson A, Johnell O, Sernbo I. A prospective randomised trial of internal fixation versus arthroplasty for displaced fractures of the neck of the femur. Functional outcome for 450 patients at two years. J Bone Joint Surg Br. 2002; 84:183–188.

26. Sikorski JM, Barrington R. Internal fixation versus hemiarthroplasty for the displaced subcapital fracture of the femur. A prospective randomised study. J Bone Joint surg Br. 1981; 63:357–361.

27. Skinner P, Riley D, Ellery J, Beaumont A, Coumine R, Shafighian B. Displaced subcapital fractures of the femur: a prospective randomized comparison of internal fixation, hemiarthroplasty and total hip replacement. Injury. 1989; 20:291–293.

28. Tarasevicius S, Jermolajevas V, Tarasevicius R, Zegunis V, Smailys A, Kalesinskas RJ. Total hip replacement for the treatment of femoral neck fractures. Long-term results. Medicina (Kaunas). 2005; 41:465–469.

29. Thompson FR. Two and a half years' experience with vatallium intramedullary hip prosthesis. J Bone Joint Surg Am. 1954; 36:489–502.

30. Tidermark J, Ponzer S, Svensson O, Soderqvist A, Tornkvist H. Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly. A randomised, controlled trial. J Bone Joint Surg Br. 2003; 85:380–388.

31. Yoon KS, Kang SB, Lee JH, Tark JS, Rhyou H. Cemented hemiarthroplasty in femoral neck fractures over 70 years: a matched-pair analysis of unipolar and bipolar hemiarthroplasty. J Korean Soc Fract. 1999; 12:773–779.