Mustafa YERLİ, Ali YÜCE, Tahsin Olgun BAYRAKTAR, Niyazi İĞDE, Bulent KARSLIOGLU, Nazım ERKURT, Mustafa Buğra AYAZ, Süleyman Semih DEDEOĞLU, Yunus İMREN, Hakan GÜRBÜZ

The effects of the choice of the femoral head in hip hemiarthroplasty on radiological and clinical outcomes

Background: A displaced femoral neck fracture in patients over 70 years of age is a severe injury that affects the patient’s quality of life. It is associated with increased morbidity and increased risk of mortality.Methods: The cases were divided into a monopolar group (n=167) and a bipolar group (n=175). Data on age, gender, ASA scores, length of stay, and other diseases were obtained from the patients’ files. Dislocation, infection and periprosthetic fracture rates were examined by examining the outpatient records of the patients in the postoperative period.Results: The mean age of all patients included in the study was 79.7±8.16 years. 62.3% (n=213) of the patients were female and 37.7% (n=129) were male. There was no significant difference between the patients in the monopolar group and the bipolar group regarding complications (p=0.743). The 30-day mortality rates of the patients in the monopolar group were significantly higher than those in the bipolar group (p=0.041).Conclusions: The use of the bipolar head in the surgical treatment of geriatric displaced femoral neck fractures with hemiarthroplasty may not provide any advantage in terms of functionality or complications.

Keywords:

Femoral Neck Fracture, Geriatric, Hemiarthroplasty, Monopolar, Bipolar.,

PDF

___

1. Guyen O. Hemiarthroplasty or total hip arthroplasty in recent femoral neck fractures? Orthop Traumatol Surg Res. 2019;105(1S): 95-101.
2. Tanoğlu O, Arıcan G, Özmeriç A, Sahin O, Iltar S, Alemdaroğlu BK. Predictors of early mortality in geriatric patients after hemiarthroplasty for femoral neck fracture. Acta Med Alanya. 2020;4(3):220-225.
3. Kristensen TB, Dybvik E, Kristoffersen M, Dale H, Engesæter LB, Furnes O, et al. Cemented or Uncemented Hemiarthroplasty for Femoral Neck Fracture? Data from the Norwegian Hip Fracture Register. Clin Orthop Relat Res. 2020;478(1):90-100.
4. Vatansever A, Öziç U, Okçu G. Assessment of quality of life of patients after hemiarthroplasty for proximal femoral fractures. Acta Orthop Traumatol Turc 2005;39(3):237-242.
5. Kaya Ş, Özdemir H, Dabak AY. İleri yaş hastalarda çimentolu ve çimentosuz hemiartroplasti sonuçlarının karşılaştırılması. Dicle Medical Journal. 2017;44(3):233-241.
6. McKinley JC, Robinson CM. Treatment of displaced intracapsular hip fractures with total hip arthroplasty: comparison of primary arthroplasty with early salvage arthroplasty after failed internal fixation. J Bone Joint Surg Am. 2002;84(11):2010-5.
7. Ogawa T, Yoshii T, Moriwaki M, Morishita S, Oh Y, Miyatake K, et al. Association between Hemiarthroplasty vs Total Hip Arthroplasty and Major Surgical Complications among Patients with Femoral Neck Fracture. J Clin Med. 2020;9(10):3203.
8. Wu X, Wang Y, Sun W, Tan M. Cemented and uncemented hemiarthroplasty for femoral neck fracture in elderly patients: a systematic review and meta-analysis. Aging Clin Exp Res. 2021;33(8):2087-111.
9. Grosso MJ, Danoff JR, Murtaugh TS, Trofa DP, Sawires AN, Macaulay WB. Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly Has a Low Conversion Rate. J Arthroplasty. 2017;32(1):150-4.
10. Aksu N, Işıklar ZU. Kalça kırıkları. TOTBİD Dergisi. 2008;7(1-2):8-19.
11. Ong BC, Maurer SG, Aharonoff GB, Zuckerman JD, Koval KJ. Unipolar versus bipolar hemiarthroplasty: functional outcome after femoral neck fracture at a minimum of thirty-six months of followup. J Orthop Trauma. 2002;16(5):317-22.
12. Shetty SH, Dhond AB, Agarwal A, Kharat A, Singh A. Intertrochanteric fracture of femur in elderly–A comparative analysis between hemiarthroplasty and osteosynthesis. Int J Orthop Sci 2017;3(1):449-52.
13. Gjertsen JE, Vinje T, Engesaeter LB, Lie SA, Havelin LI, Furnes O, et al. Internal screw fixation compared with bipolar hemiarthroplasty for treatment of displaced femoral neck fractures in elderly patients. J Bone Joint Surg Am. 2010;92(3):619-28.
14. Dai Z, Li Y, Jiang D. Meta-analysis comparing arthroplasty with internal fixation for displaced femoral neck fracture in the elderly. J Surg Res. 2011;165(1):68-74.
15. Zehir S, Şahin E, Sipahioğlu S, Azboy İ, Yar Ü. Femur boyun kırıklarına parsiyel protez uygulamasında anterior ve posterior kapsüler açılımın sonuçları. Ulus Travma Acil Cerr Derg. 2013;19(5):456-462.
16. Sevinç HF. Dissociation of bipolar components following bipolar hemiarthroplasty: A report of two different cases and review of the literatüre. Ulus Travma Acil Cerrahi Derg, 2021;27(5):600-603.
17. Haidukewych GJ, Israel TA, Berry DJ. Long-term survivorship of cemented bipolar hemiarthroplasty for fracture of the femoral neck. Clin Orthop Relat Res. 2002;(403):118-26.
18. Solak Ş, Oğuz T, Bektaşer B, Adabağ C. Comparison of the two types of endoprosthesis in the treatment of intracapsular hip fractures in elderly patients. Joint Dis Rel Surg 2002;13:1-4.
19. Bölük K, Bilgen MS, Durak K. İleri yaş ayrılmış femur boyun kırıklarında unipolar ve bipolar protez uygulamaları. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2008;34(2):41-44.
20. Khan RJ, MacDowell A, Crossman P, Keene GS. Cemented or uncemented hemiarthroplasty for displaced intracapsular fractures of the hip--a systematic review. Injury. 2002;33(1):13-7.
21. Parker MJ, Gurusamy KS, Azegami S. Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev. 2010;(6):CD001706.
22. Moerman S, Mathijssen NMC, Niesten DD, Riedijk R, Rijnberg WJ, Koëter S, et al. More complications in uncemented compared to cemented hemiarthroplasty for displaced femoral neck fractures: a randomized controlled trial of 201 patients, with one year follow-up. BMC Musculoskelet Disord. 2017;18(1):169.