Functional outcome of fracture neck of femur treated with total hip replacement versus bipolar arthroplasty in a South Asian population

Abstract

Endoprosthetic replacement is a popular method of treatment for fracture neck of femur in the elderly. Unipolar, bipolar and total hip endoprosthesis are all used. The aim of this paper is to compare the functional results of bipolar arthroplasty with that of total hip arthroplasty in a South Asian population. Sixty-one patients who underwent prosthetic replacement for fracture neck of femur between May 1997 and Dec 2002 were followed-up prospectively. Twenty-nine patients were treated with total hip replacement and thirty-two were treated with bipolar arthroplasty. At the time of the last follow-up, twenty-four patients had expired and seventeen could not be traced. The results in the remaining twenty are presented. The period of follow up ranged from 24 months to 90 months, with a mean of 58.5 months. The mean Harris Hip Score for the bipolar group was 86.93, and for the total hip group was 83.82. More than a third of our patient population died within 5 years of endoprosthetic replacement. The functional outcome is equally good whether bipolar or total hip replacement is used, in the elderly, in a South Asian population. More than a third of our patient population expired within 5 years of prosthetic replacement; therefore it may be wise to choose the less expensive treatment modality in resource poor countries.