Bagcilar Medical Bulletin (Sep 2021)
The Effect of Endoprosthesis Selection on Functional Outcomes in the Elderly with Femoral Neck Fractures
Abstract
Objective:Hemiarthroplasty is the most common treatment for femoral neck fractures in patients aged ≥60 years. In this study, we aimed to compare the functional outcomes of unipolar and bipolar endoprostheses used in hemiarthroplasty in the elderly with femoral neck fractures.Method:A total of 63 patients aged ≥60 years, who underwent hemiarthroplasty for femoral neck fractures between 2004 and 2019, were included. A unipolar and bipolar endoprosthesis was applied to 36 and 27 patients, respectively. All patients were followed for minimum 12 months. The fractures were assessed using the Pauwels classification. Demographic and clinical characteristics of the patients were recorded. Postoperative hip function was evaluated using the Harris hip score (HHS).Results:The mean age was 74.1±7.3 years in the unipolar endoprosthesis group and 72.9±8.3 years in the bipolar endoprosthesis group. There was no significant difference in the age, sex, and localization of the fracture between the groups. A significant difference in the fracture types according to the Pauwels classification was observed between the two endoprosthesis groups (p<0.01). Follow-up duration, dislocation, reoperation, and wound infection were similar between the groups. The mean limp, ability of putting on socks, mobility, and ability of using public transportation subscale scores of the HHS were significantly higher in the patients undergoing bipolar arthroplasty (p=0.014, p=0.020, p=0.026, and p=0.03, respectively). However, the total HHS was comparable between the groups (p=0.728).Conclusion:Our study results show that bipolar arthroplasty yields more favorable results in patients with a better predictable mobilization based on the HSS subscale scores. Of note, unipolar arthroplasty is a more low-cost treatment method in the elderly patients with femoral neck fractures.
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