A Comparison Of The Bipolar Hemiarthoplasty With Or Without Cement For The Displaced Femoral Neck Fractures In Elderly Patients

Objective To evaluate the outcoms of the bipolar hemiarthroplastywith or without cement for the displaced femoral neck fractures in elderlypatients..Methods Between Janurary1998and Janurary2011,62patients (62hips) with displaced femoral neck fractures were performed the bipolarhemiarthroplasty fixed with or without cement in the First Affiliated Hospitalof Soochow University and Liyang People’s Hospital. There were30hips(average70years old) in the cemented group and32hips (average80yearsold) in the cementless group. In the cemented group, three different stemswere applied,16stems with similar geometry of Austuin Moore,8stemssimilar with Thompson design as well as6stems similar with Bateman design.Porous, tapered stems wers inserted in the cementless group. Datum werecollected and assessed between the two groups, including surgical time,intraoperative blood loss,average hospital stay, average ambulation time aswell as Harris Hip Scores. The criteria used to define loosening of thecemented femoral component have been previously reported by Harris et al. The stability of the uncemented femoral component was classified as boneingrown, stable fibrous ingrown, or unstable by Engh et al.Results No intraoperative complications occured, such as shock,cardiopulmonary arrest and neurovascular injury. There were aslo nopostoperative complications, including dislocation, infection and pulmonaryembolism. There were significant difference in the surgical time, total bloodloss and average hospital stay between the cemented fixation group and theuncemented fixation group (p<0.0001). The two groups differed significantlywith regard of the average ambulation time, which was eight days in thecemented group and six day in the uncemented group. The average Harris hipscores in the group treated with cement (84±5points) and the group treatedwithout cement (82±7points) were similar and not significant different at thetime of six months after operation. It was similar of the average Harris hisscores at one year after operation in the cemented group and uncementedgroup,86±4and85±4points,respectively. There were no significantdifference in terms of excellent and good rates of the clinical outcome,86%inthe cemented group and82%in the uncemented group respectively.Conclusions1. In comparison with internal fixation or conservativetreatment, bipolar arthroplasty for the treatment of a displaced femoral neckfracture significantly improves the function and the heath-related quality ofthe life and reduces the risk of avascular necrosis of femoral head and the nonunion, both of which are serious problems following internal fixation.2. There was no significant difference in terms of hip function afterbipolar arthroplasty was performed for the the femoral neck fracture in theelderly patients with or without cement.3. It is recommended that displaced femoral neck fractures in the elderlyshould generally be treated by bipolar arthroplasty without cement.