Unipolar Austin Moore’s Prosthesis versus Cemented Bipolar Arthroplasty in Displaced Neck of Femur Fracture, in Elderly Patients RC01-RC04
Dr. Balaji Zacharia,
Additional Professor, Department of Orthopedics, Government Medical College, Kozhikkode-673008, Kerala, India.
Introduction: The incidence of hip fracture among the Asian population has been on the rise. Due to higher rate of complications in osteosynthesis, arthroplasty is a preferred treatment. Hemiarthroplasty can be done using uncemented unipolar Austin Moore prosthesis and cemented bipolar arthroplasty.
Aim: To assess out the anatomical and functional outcome in elderly patients, treated with unipolar/bipolar prosthesis for displaced fracture neck of femur.
Materials and Methods: A prospective comparative study was conducted, involving 48 patients. Elderly patients between 60 and 75 years of age, with displaced fracture neck of femur, were included. 29 patients were operated with Austin Moore Prosthesis (AMP) and 19 with bipolar prosthesis. Results on continuous measurements are presented on mean value (minimum –maximum) and results on categorical measurements are presented in number (%), variables were correlated wherever relevant. The functional hip score was assessed using Harris Hip Score (HHS). The statistical software SPSS 15.0 (Statistical Package for Social Sciences) was used for the analysis of data and Microsoft’s Word and Excel were used to generate tables and figures.
Results: The average duration of time for AMP was 44.97 minutes and for bipolar 53.05 minutes. The total blood loss was 263.1 mL (intraoperative) and 319 ml (postoperative) in the AMP group. The blood loss was about 329.37 ml (intraoperative) and 393.15 mL (postoperative) in bipolar group which showed a statistically significant difference. Harris Hip Score was 60.64 and 70.84 for AMP and Bipolar group respectively at final follow up. There was no significant difference in pain score between the two groups. There were three cases of femoral stem subsidence and two cases of acetabular erosion in the AMP group.
Conclusion: Cemented bipolar prosthesis is a better choice for displaced fracture neck of femur in the elderly.