Comparative analysis of functional outcomes of different modalities of hemiarthroplasty in the treatment of fracture neck of femur in an elderly population of rural Bengal

Abstract

Background: Arthroplasty of one form or another is an appropriate treatment for many patients with a displaced femoral neck fracture; there is an ongoing controversy about the relative merits of different types of arthroplasty among specific groups of patients. Aims: This study was conducted to compare functional outcomes of different modalities of hemiarthroplasty (HA) in the treatment of fracture neck of femur in an elderly population of rural Bengal. Materials and Methods: This study was conducted in a time span of 3 years after taking Institutional ethical clearance and informed consent of the subjects. In the study 20 patients in each modality of HA (Austin Moore [AM] prosthesis, cemented Thompson prosthesis and cemented bipolar prosthesis) were taken into consideration. First generation cementing technique was applied. The cases were assessed on the basis of Harris Hip Score (HHS). Results: At 6 months follow-up satisfactory results of AM was −56%, Thompson was 80% and bipolar was 85%. At 12 months of follow-up satisfactory results of AM prosthesis was 60.5%, Thompson was 87% and bipolar was 91%. After 2 years average HHS of AM prosthesis was about 60%, Thompson prosthesis was 86% and the bipolar prosthesis was 91%. Conclusions: The functional outcome was relatively better in cemented bipolar and cemented Thompson group. Most of the unsatisfactory result (unipolar) group was due to shortening, acetabular erosion, and anterior thigh pain. Therefore, it should not be recommended in all cases of intracapsular fracture neck of the femur with poor bone quality relatively less physiological age. Bipolar and Thompson almost equal clinical and radiological outcome in clinical practice in such cases. Cemented Thompson may provide equally effective satisfactory outcome in comparison to nonmodular bipolar prosthesis.