Why the study?
Functional outcomes in terms of post-operative mobility for unipolar versus bipolar un-cemented hemiarthroplasty in elderly patients with displaced intracapsular femoral neck fractures were compared due to uncertainty about which prosthesis yields better mobility.
Does bipolar un-cemented hemiarthroplasty improve functional outcomes in terms of post-operative mobility compared to unipolar hemiarthroplasty in elderly patients with displaced intracapsular femoral neck fractures?
RCT (n=138)
Single-blind
Lottery method
No
Does bipolar un-cemented hemiarthroplasty improve functional outcomes in terms of post-operative mobility compared to unipolar hemiarthroplasty in elderly patients with displaced intracapsular femoral neck fractures?
Absolute Event Rate: 40.6% vs 14.5%
p-value: p=0.027
Bipolar un-cemented hemiarthroplasty provides better functional mobility outcomes than unipolar hemiarthroplasty for displaced intracapsular femoral neck fractures in elderly patients.
Bipolar uncemented hemiarthroplasty improves post-operative mobility versus unipolar in elderly femoral neck fractures; reinforces RCT evidence supporting bipolar preference.
Objectives: To compare of functional outcomes in terms of post-operativemobility for unipolar versus bipolar un-cemented hemiarthroplasty in elderly patients withdisplaced intracapsular femoral neck fractures. Study Design: Randomized Control Trial.Setting: Department of Orthopedics Bahawal Victoria Hospital, Bahawalpur. Period: April 2015to October 2016. Methodology: Sample size is (calculated by taking n6 =138, confidenceinterval 95, power of study 80, P1= 33%, P2=13%) 69 in each group. Sampling technique usedwas non probability consecutive sampling. All patients who meet the inclusion criteria presentingto orthopedic unit of Nishtar Hospital Multan with fracture neck of femur were selected for study.Patients were divided into two groups randomly by lottery method and enrolled for unipolaror bipolar hemiarthroplasty. Chi-square test was used to compare outcome variable in bothgroups. A p-value < 0.05 was considered statistically significant. Effect modifiers like age andsex was controlled by stratification. Chi square test was applied to see significant difference.Results: Overall, there were 100% (n=138) patients in this study, both genders. The mean ageof the patients was 66.35±4.29 years. (Range: 60 to 80years)Mean age and SD of group A (nowalking aid) was 54.52 ± 3.10 and in group B (walking aid) 54.99 ± 3.19. Time up go score wasnoted as successful 33.3% (n=46) and 66.7% (n=92) as unsuccessful. Walking aid was notedin 65.2% (n=90) patients. Functional outcome was noted as good in 26.8% (n=37) patientsand noted as bad in 73.2% (n=101) patients. Out of 100% (n=38) patients, good outcomewas 26.3% (n=10) unipolar and 73.7% (n=28) bipolar. Out of 100% (n=100) Bad outcomewas 59% unipolar and bipolar 41%. Conclusion: Functional outcome in term of mobility isbetter in case of bipolar prosthesis as compared to unipolar. Thus in our conclusion bipolarprosthesis is preferred procedure as compared to unipolar hemiarthroplasty in treating patientswith displaced intracapsular femoral neck fracture.
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Ahmed et al. (2018) conducted an RCT in Displaced intracapsular femoral neck fractures (n=138). Bipolar un-cemented hemiarthroplasty vs. Unipolar un-cemented hemiarthroplasty was evaluated on Functional outcome in terms of independent mobility (good outcome) measured by The Timed Up and Go Test and use of walking aid at 12 weeks (p=0.027).
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