Evaluation of Cemented Bipolar Hemiarthroplasty to Assess Functional Outcome of Displaced Femoral Neck Fractures in Elderly Osteoporotic Patients

Author(s): Khandoker Abdur Rahim, Khandker Md. Nurul Arifeen, Rokshana Begum, Sk. Murad Ahmed, Nadia Zebin Khan, Zafri Ahmed, Faisal Ahmed, Md. Mahabub Hosen, Md Hamidul Islam, A. K. M Shahidur Rahman

Background: Hip fractures are the most frequent injury among elderly patients. The incidence is increasingly prevalent worldwide, particularly in the older age group as one common risk factor for both sexes is osteoporosis. Cemented hemiarthroplasty is one of several surgical treatment options for displaced femoral neck fractures, and it is promising for elderly osteoporotic patients.

Objective: This study was aimed to evaluate the functional outcomes of cemented bipolar hemiarthroplasty in treating displaced femoral neck fractures among elderly osteoporotic patients.

Methods: This quasi-experimental study was conducted at the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from March 2022 to March 2024. We evaluated the functional outcomes of cemented bipolar hemiarthroplasty in the treatment of displaced femoral neck fractures among 15 elderly osteoporotic patients. All study patients were assessed pre-operatively and followed up post-operatively at 1, 3, 6, and 12 months accordingly. Data were analyzed and compared by statistical tests.

Results: The mean(±SD) age of the study patients was 67.93±8.03 years, most (60%) of them was aged between 61-70 years. Females constituted 70% of the total participants, with a male-to-female ratio was 1:2. Comorbidities included hypertension (26.67%), diabetes mellitus (33.33%), and both conditions (20%). Right-sided injuries were more common (53.33%). Garden type IV fractures were predominant (60%), and 86.67% of cases was Dorr type C. The mean hospital stay was 6.93±1.44 days, mean blood loss was 216±34.6 ml and mean duration of surgery was 96.67±15.43 minutes. The Harris Hip Score improved significantly from 62.87±2.39 at 1 month to 89.40±1.97 at 12 months (p<0.001). Superficial infection and wound hematoma were found in 6.7% of patients each.

Conclusion: Cemented bipolar hemiarthroplasty for displaced femoral neck fractures among elderly osteoporotic patients provides a good functional outcome, pain relief, and a quick return to independent activity with a manageable risk of complications.