Functional Outcomes after Total Hip Arthroplasty versus Hemiarthroplasty for the Treatment of Displaced Femoral Neck Fracture in Active Elderly Patients

Abstract

Abstract Background Fracture neck of femur has always been a great challenge to orthopedic surgeons, the aim of the management is early ambulation and good functional outcome also avoiding complications and reoperation as the elderly patients often have several comorbidities. Aim of the Work To analyse Functional hip outcome as the primary end-point, after a displaced fracture of the femoral neck in a relatively healthy, active elderly patient who receive either a bipolar hemiarthroplasty or a Total Hip Arthroplasty. Patients and Methods Retrospective Cohort study was conducted at Ain Shams university hospitals recruiting 20 active patients aged from 60 to 80 years old with fracture neck of femur starting from January 2021 till January 2022. We excluded patients with grade 3 hip osteoarthritis (Tonnis classification), acetabular dysplasia and with previous ipsilateral hip surgeries. Patients were in 2 groups each 10 patients one for THA and the other for BHA. The follow up period was 1 year. Results In this study, we found that the duration of surgery, blood loss, and amount of blood transfusion were considerably less in the BHA group. These findings corroborate with the results of multiple studies and reviews on the topic conducted in the past both in the western and Indian populations. In elderly patients, the treatment outcome is significantly affected by the duration of surgery and the amount of blood loss. Conclusion For the healthy elderly with displaced FNFs. None of these treatment options (THA, BHA) appeared to be superior with respect to mHHs as indicator to Functional outcomes. BHA led to better outcomes regarding dislocation rate, while THA was more favorable regarding reoperation rate.