Prospective study of short term functional outcome in elderly patients treated with cemented vs uncemented bipolar hemiarthroplasty for transcervical neck of femur fractures

Objective: Transcervical femur neck fractures are common occurrences in elderly age group leading to significant impact in the health care setup. Bipolar hemiarthroplasty is the commonly performed surgery in this age group. There has been an ongoing debate based on outcome of cemented vs uncemented hemiarthroplasty. The purpose of the study is to evaluate the functional outcome with individual techniques assessed by the Harris Hip Score. Materials and Methods: It was a single centre prospective study with the total sample size of 50. Randomisation was done into 2 groups, one to be treated with uncemented bipolar hemiarthroplasty and the other one with cemented hemiarthroplasty. The comparison was done based on the demographic data, intraoperative parameters, post-operative complications and functions. The patients were followed up till one year and functional outcome was evaluated using the Harris Hip Score. Results: The average age of the patients in the study is 75.02 years, with most patients between 70 -80 years and females (54%) being more than males (46%). Surgical time and blood loss was greater for the cemented (94.4min and 234.8ml) cohort than the uncemented (60.80 min surgical time and 183.20 ml blood loss) (p value < 0.001). However the functional outcome at the end of one year was the similar in both the study groups. Mean Harris Hip Score at 1 year for cemented group was 94.1 and uncemented group was 94.43 with p value = 0.862 (not significant). Conclusion: Based on our results the advantages of using an uncemented hemiarthroplasty are less intraoperative bleeding, shorter duration of surgery which was statistically significant. Both cemented and uncemented hemiarthroplasty are accepted modality of treatment in transcervical femur neck fractures in elderly, as there is no statistical difference in the functional outcome at the end of one year.