Lower Creatine Kinase, IL-6 Levels and Femoral Offset Values Lead to Better Outcome Harris Hip Score Post Bipolar Hemiarthroplasty Surgery Day 14 and Day 30

Abstract

Bipolar Hemiarthroplasty (HA) procedure allows patients after a neck femur fracture to be able to perform early mobilization. Hence complications due to prolonged bed rest could be prevented. Early mobilization should be achieved immediately after bipolar HA surgery. There are several factors affecting early mobilization in patients, some of which include tissue damage during surgery (creatine kinase), inflammatory status of patients (IL-6) and implant position (femoral offset). This study aims to show whether lower levels of creatine kinase, IL-6 and femoral offset can result in better Harris Hip Score following Bipolar HA surgery day 14 and day 30. By knowing the influencing factors, it is hoped that more accurate management could be carried out. Thus, the outcome parameters of early mobilization in the form of returning to daily life and work activities are getting better and the risk of complications can be avoided. This study compared the Harris Hip Score (HHS) in patients who'd already had Bipolar Hemiarthroplasty using a prospective cohort study design (Bipolar HA) who met the inclusion criteria at the Central General Hospital (RSUP) Prof I.G.N.G Ngoerah Denpasar and provided them informed consent. In order to do descriptive analysis, normality and homogeneity tests, and proportion comparison analysis, the research data was entered into a research sheet and processed using a computer and the SPSS for Windows version 26 program. In this study, the sample data (n=32) was not normally distributed. Lower levels of IL-6 (< 15 pg/ml), and FO values ​​(​​< 42.5 mm) resulted in better HHS values ​​in patients following Bipolar HA surgery day-14. Additionally, lower levels of CK (< 75 U/L), IL-6 (< 15 pg/ml), and FO values (​​< 42.5 mm) ​​resulted in better HHS values ​​in patients following bipolar HA surgery on day-30. Chi-Square analysis showed that the results of CK levels day-14 were statistically insignificant (p= 0.072>0.05), while the results of CK levels day-30 were statistically significant (p=0.033<0.05). Moreover, chi-Square analysis showed that the results of day-14 and day-30 were statistically significant on IL-6 levels (p-0.016<0.05 and p= 0.015<0.05), and FO values (p= 0.012<0.05 and p-0.033<0.05). It is concluded that lower levels of IL-6, and FO values resulted in better HHS values in patients following Bipolar HA surgery day-14. Additionally, lower levels of CK, IL-6, and FO values resulted in better HHS values in patients following bipolar HA surgery on day-30.