Cemented Vs Uncemented modular Bipolar hemiarthroplasty treatment for femoral neck fracture in elderly patients

Abstract

ObjectivesFemoral neck fractures in the elderly are associated with high morbidity and mortality. The optimal treatment remains controversial regarding the use of cement in hemiarthroplasty when treating a displaced femoral neck fracture in elderly patients. The primary hypothesis of this study was that the use of cement would afford better visual analog pain and activity scores in elderly patients. MethodsThis study included 84 patients over 64 years of age with fracture neck femur treated with cemented and uncemented Modular Bipolar hemiarthroplasty. The patients (49 female, 35 male; mean age: 79.5 years; range: 64–95 years) included and were followed-up regularly till 02 years. Patients were divided equally into two groups: group A(n=42) was treated with cement; and group B(n=42) without cement. Both groups were compared in terms of preoperative features (demographics and associated diseases), pre- and postoperative complications, mortality rates, pain and activity levels, and hip scores. ResultsWe found no statically significant between-groups differences in terms of length of hospital stay, Harris Hip Score and complications. However in Uncemented group 03 patients developed loosening of implant at the end of 2year without any clinical of biochemical sign of infection. Walking ability and pain scores were better in the cemented group in the early follow-up period. ConclusionBased on our study we reached the conclusion that the use of cement during hip hemiarthroplasty in patients over 64 years of age who invariably has osteoporotic bone and wide femoral canal had no negative impact on mortality or morbidity. Hemodynamic changes during cement application are important, but it is noteworthy that patients fitted with cemented endoprostheses had increased levels of activity and lower pain levels.