Key result
Bipolar hemiarthroplasty significantly improved functional outcomes at 6 months compared to unipolar hemiarthroplasty (mean Harris hip score 84.97 vs 73.4, p=0.012), but this difference was no longer significant at 12 months.
Why the study?
Femoral neck fractures are a major cause of morbidity and mortality in elderly patients, prompting a comparison of functional outcomes between unipolar and bipolar hemiarthroplasty.
Does bipolar hemiarthroplasty improve functional outcomes compared to unipolar hemiarthroplasty in elderly patients with femoral neck fractures?
RCT (n=60)
Open-label
Randomly allocated
No
Does bipolar hemiarthroplasty improve functional outcomes compared to unipolar hemiarthroplasty in elderly patients with femoral neck fractures?
Absolute Event Rate: 84.97% vs 73.4%
p-value: p=0.012
Bipolar hemiarthroplasty provides better early functional outcomes at 6 months compared to unipolar hemiarthroplasty, but both offer similar functional results at 12 months for elderly patients with femoral neck fractures.
Bipolar hemiarthroplasty may favor early recovery in femoral neck fractures; challenges sustained superiority over unipolar at 1 year.
Background: Femoral neck fractures occur most commonly in elderly females and are a major cause of morbidity and mortality in this age group and require immediate and appropriate management. Aim of the study was to compare the functional outcome of unipolar Austin Moore's prosthesis (AMP) hemiarthroplasty (HA) and bipolar (BHA) HA with femoral neck fractures using Harris hip score system. Methods: The study was conducted on 60 patients aged above 50 years with fractured neck of femur admitted in Vinayaka missions Kirupananda Variyar medical college and hospital from August 2017 to August 2019. Patients with femoral neck fracture were allocated randomly to have 30 cases of AMP. Results: Out of the 60 cases, the patients in the bipolar (nonmodular) HA group II showed better functional outcomes compared to unipolar (AMP) HA group I after six months follow-ups. At 12 months of follow-up, there was no significant difference between group I (AMP) and group II (BHA). Conclusions: Our study demonstrates, hemiarthroplasty of the hip for femoral neck fractures is a good option in elderly patients. The mortality and morbidity are not high, the operative procedure is simple, complications are less disabling, early weight-bearing and functional results are satisfactory and second surgery are less frequently required.
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Raja et al. (2021) conducted an RCT in Femoral neck fracture (n=60). Bipolar hemiarthroplasty vs. Unipolar hemiarthroplasty was evaluated on Mean Harris hip score at 6 months (p=0.012). Bipolar hemiarthroplasty significantly improved functional outcomes at 6 months compared to unipolar hemiarthroplasty (mean Harris hip score 84.97 vs 73.4, p=0.012), but this difference was no longer significant at 12 months.
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