Comparison of Functional Outcomes in Terms Of Post-Operative Mobility for Unipolar Versus Bipolar Un-Cemented Hemiarthroplasty in Elderly Patients with Displaced Intracapsular Femoral Neck Fractures

Abstract

Objective: To compare of functional outcomes in terms of post-operative mobility for unipolar versus bipolar un-cemented hemiarthroplasty in elderly patients with displaced intracapsular femoral neck fractures.

Methodology: Our study design is Randomized Control Trialconducted inDepartment of Orthopedics Bahawal Victoria Hospital, Bahawalpur. April 2015 to October 2016.Sample size is (calculated by taking n⁶ =138, confidence interval 95, power of study 80, P1= 33%, P2=13%) 69 in each group. Sampling technique used was non probability consecutive sampling. All patients who meet the inclusion criteria presenting to orthopedic unit of Nishtar Hospital Multan with fracture neck of femur were selected for study. Patients were divided into two groups randomly by lottery method and enrolled for unipolar or bipolar hemiarthroplasty. Chi-square test was used to compare outcome variable in both groups. A p-value < 0.05 was considered statistically significant. Effect modifiers like age and sex was controlled by stratification. Chi square test was applied to see significant difference.

Results: Overall, there were 100% (n=138) patients in this study, both genders. The mean age of the patients was 66.35±4.29 years. (Range: 60 to 80years) Mean age and SD of group A (no walking aid) was 54.52 ± 3.10 and in group B (walking aid) 54.99 ± 3.19. Time up go score was noted as successful 33.3% (n=46) and 66.7% (n=92) as unsuccessful. Walking aid was noted in 65.2% (n=90) patients. Functional outcome was noted as good in 26.8% (n=37) patients and noted as bad in 73.2% (n=101) patients. Out of 100% (n=38) patients, good outcome was 26.3% (n=10) unipolar and 73.7% (n=28) bipolar. Out of 100% (n=100) Bad outcome was 59% unipolar and bipolar 41%.

Conclusion: Functional outcome in term of mobility is better in case of bipolar prosthesis as compared to unipolar. Thus in our conclusion bipolar prosthesis is preferred procedure as compared to unipolar hemiarthroplasty in treating patients with displaced intracapsular femoral neck fracture.

Keywords:Bipolar Hemiarthroplasty, Unipolar Hemiarthroplasty, Displaced intracapsular femoral neck fractures.