CEMENTLESS BIPOLAR HEMIARTHROPLASTY FOR FEMORAL NECK FRACTURE IN PATIENTS OLDER THAN SEVENTY YEARS USING TAPERED RECTANGULAR STEM

Abstract

Purpose: The purpose of this study was to evaluate clinical and radiological outcomes after cementless bipolar hemiar-throplasty in elderly patients with femoral neck fractures.

Materials and Methods: Eighty hips – all in patients greater than 70 years of age – were followed for more than 2 years after undergoing cementless bipolar hemi-arthroplasty with a tapered rectangular cementless stem (Lima SPH-C2^®). The mean age was 76 years, and the mean follow-up period was 37 months. The Harris hip score and postoperative hip pain were analyzed clinically. Femoral bone types were classified according to Dorr method. The radiological results were assessed using various radiological indices.

Results: At last follow-up, the mean Harris hip score was 80.2 points. There were 5 cases of groin pain, 4 (5.0%) mild and 1 (1.3%) moderate and 7 cases of thigh pain, 6 (7.5%) mild and 1 (1.3%) moderate. Fifty-five cases (68.7%) showed no decrease in ambulation capacity postoperatively. Patients have type A bone types in 13 cases(16.2%), type B in 51 cases(63.7%) and type C in 16 cases(20.0%). Radiologically, there were 47 cases (58.7%) of bone ingrowth and 33 cases (41.3%) of stable fibrous fixation. There were no cases of osteolysis, and 30 cases (37.5%) exhibited new bone formation around the stem. All stems were stable without significant alignment change or progressive subsidence.

Conclusion: Short-term outcomes proved to be satisfactory in elderly patients undergoing cementless bipolar hemiarthroplasty for femoral neck fractures. Tapered rectangular stem showed satisfactory results with all bone morphology.