Comparative study on functional outcomes of bipolar hemiarthroplasty versus total hip arthroplasty in elderly patients with displaced femoral neck fractures

Abstract

Objective: To compare the functional outcomes of bipolar hemiarthroplasty (BHA) versus total hip arthroplasty (THA) in elderly patients with displaced femoral neck fractures (DFNFs).

Methodology: This was a retrospective comparative study. Ninety-two elderly patients with DFNFs who were treated at Peking University First Hospital from January 2022 to October 2023 were enrolled in the study. The participants were randomly assigned into an observation group (BHA, n=46) and a control group(THA, n=46) using a random number table. Perioperative parameters were compared and complications were analyzed between the two groups. Postoperative pain was rated using the Visual Analog scale (VAS) at 12, 24, 48 and 72 hours and seven days postoperative. The Harris Hip Score (HHS) was recorded at one month(T1), three months(T2), six months(T3) and one year(T4) postoperative.

Results: The observation group significantly outperformed the control group in duration of operation (DoO), intraoperative blood loss (IBL), postoperative drainage volume (PDV), length of hospital stay (LoHS), incision length (IL) and ambulation time (AT) (P<0.05, respectively). The two groups exhibited significant time, group and group-by-time interaction effects for both the VAS and HHS (P< 0.05, respectively). The observation group had lower VAS scores at 12, 24, 48 and 72 hours post-surgery and higher HHS at T1 and T2 compared with the control group (P < 0.05, respectively).

Conclusion: For elderly patients with DFNFs, BHA, compared with THA, offers shorter DoO, less surgical trauma and better early functional recovery, facilitating postoperative rehabilitation while reducing surgical risks.