BIPOLAR VERSUS TOTAL HIP ARTHROPLASTY IN FEMORAL NECK FRACTURES

Abstract

Purpose: The aim of our study is to compare the outcome of Bipolar Artroplasty (BA) and Total Hip Arthroplasty (THA) in active middle-aged patients with displaced intracapsular femoral neck fractures. Material and Methods: From October 1993 until October 1997, 43 patients (6 male, 37 female) were treated with the above two methods (25 underwent BA and 18 THA), when satisfactory reduction of the fracture was not achievable or survival of femoral head was uncertain. The patients were from 55 to 76 years of age (mean 64, 8 years).

Thirty-eight patients (22 with BA and 16 with THA) were reviewed after a mean of 5, 8 years (ranging from 3 to 8 years).

Results: Comparing the clinical results we found no statistical significant difference between the two methods. Mean Harris Hip Score in BA was 89 (range 71–100) and in THA was 88 (range 74–100). The motion of the inner component of BA was 24% of total in weightbearing conditions and 17, 7% in non-weightbearing condition, as it was measured radiographically.

Conclusion: Despite our small number of patients, the results of BA are comparable to those of THA. Considering that BA it’s a more simple method, reduces the operation time, eliminates blood transfusions and is less expensive, it seems that BA is a rational method of treatment for this group of patients. THA should be reserved for patients with displaced femoral neck fractures with pre-existing hip disease (rheumatoid arthritis, osteoartritis, Paget disease).