Similar Short Term Outcomes with Press-fit Bipolar Hemiarthroplasty and Cemented Total Hip Replacements in Femoral Neck Fractures

Abstract

There is limited data of short-term outcomes comparing press-fit bipolar and cemented total hip replacements in patients with femoral neck fractures. We therefore aimed to compare the perioperative incidents and immediate outcomes between press-fit stem bipolar head hemiarthroplasty and cemented total hip replacement in elderly patients with displaced femoral neck fractures. We reviewed prospectively collected data from 115 consecutive patients over 12 months. There were 21 cemented total hip replacements and 33 bipolar head press-fit stem hemiarthroplasties, with a male to female ratio of 1:1.84 and an average follow-up of 9.9 months (range 3-15). There were no differences between the two groups with respect to age (mean 77.4 years old), cortical index (0.77/ 0.82, p=0.087), hospitalization (17.7/ 16.7 days, p=0.59), bleeding, blood transfusions (14.3/ 18.2%, p=1.00) and Barthel index preoperatively, at discharge and 3 months (5.67/ 5.48, p=0.62; 10.57/ 10.47, p=0.89; 13.81/ 13.28, p=0.47). For all 54 patients the hemoglobin dropped from 13 to 11.2 g/dL after surgery without difference between implants. The mean duration of surgery was 21minutes (p[0.01) shorter for the press-fit hemiarthroplasty group compared to cemented total hip replacements. Our findings show comparable blood loss and functional outcomes with press-fit bipolar hemiarthroplasty and cemented total hip replacements for treating displaced femoral neck fractures in the elderly. Both were safe and allowed early recovery, with the only significant difference being the longer duration of surgery for the total arthroplasty.