Jagdesh Kumar, Muhammad Umar, Ansar Shafiq Ahmad, Sharjeel Asif, Raja Shehzad.
Bipolar cemented hip hemiarthroplasty in elderly patients with femoral neck fractures.
J Pak Orthop Assoc Jan ;24(2):62-8.

Objective: To evaluate the clinico-radiological outcome of bipolar cemented hip hemiarthroplasty in a series of mobile elderly patients with femoral neck fractures. Study Design: Descriptive Case series Study Place and Duration of Study:Institute orthopaedic and Surgery Karachi during theperiod from Jan 2009- to March 2012 Patients and Methods: A total of 70 femoral neck fractures treated with cementless bipolar hemiarthroplasty were analyzed. 52(74.2%) were females and 18(25.8%) were males Average age of patient was 61.5 years. Out of 70, 54(77%)had a history of simple fall. Average time from injury to surgery was 5.8 days and Average time to discharge from hospital after surgery was 6.3 days (range 6 16 days). The average duration of surgery was 48.4 minutes from skin to skin (range 43 75 minutes). The mean follow up period was 13.8 months (range 6 months to 26 months). All of these patients achieved pre-injury walking status at 3 months. We had no instances of dislocation. 3 (4.2%) patients died due to medical condition (8 14 months post-surgery). 2 (2.8%) cases developed superficial wound infection and 2(2.8%) patients had limb length discrepancy of < 2 cm. Results: At the latest follow-up, the average Harris Hip Score was 86.4 (range 69 to 96). The outcome was considered excellent or good in 49 hips, fair in 20 hips and poor in 1 hip. The pain score was 0 in 31 patients, between 1 and 4 in 34 patients, between 5 and 8 in 5 patients and pain score more than 8 in 0 patients. The mean pain score was calculated to be 1.4 (0 10).16 patients were mobilized with crutches or walker. 4 patients were unable to ascend or descend stairs independently without use of aids due to generalized weakness. The other patients were ambulatory without support. All femoral stems were radiologically stable shows no sign of loosening. There were no case with > 50 varus or valgus displacement or femoral stem subsidence > 3 mm, acetabular erosion, acetabular protrusion or hypertrophic ossification in any of the patients during the study period. None of the patients need revision or conversion to total hip replacement to date. None of the patients died during the post-operative hospitalization period. Conclusion: We believe that cemented, bipolar hemiarthroplasty is an effective method for femoral neck fractures in mobile elderly patients with poor bone stock.The majority of the patients in this study reported none to minimal post-operative complication with early restoration of premorbid walking ability and quality of life.

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