Bipolar Hemiarthroplasty for fracture of femoral Neck: Clinical review with special emphasis on prosthetic motion by Radiological evaluation

Abstract

Introduction: Intracapsular femoral neck fractures are common in the elderly population. To avoid the poor outcome of internal fixation and for early mobilization, hemiarthroplasty is performed. Aims & Objective: To study the management of fracture neck of femur by bipolar prosthesis and to study post-operative prosthetic components motion radiologically. Materials & Methods: Thirty patients with fracture neck of femur were treated using fixed angle bipolar hip prosthesis. All patients were assessed post operatively radiologically at 1 ½, 3 and 6 months follow up. Patients with Avascular necrosis, Osteoarthritis and insufficient calcar size for implanting bipolar prosthesis were excluded. Radiologically prosthetic motions were evaluated in neutral position, 20° & 40° abduction and 20° adduction. Results: Study shows that mean motion in the outer component & the acetabulum was higher than motion between inner component & the acetabulum in immediate, 1 ½, 3 and 6 months follow up. Main complaint of patients was pain in operated hip. Conclusion: In a country like India, in rural population considering their economic status, the use of fixed angle bipolar prosthesis in fracture neck of femur was associated with more motion in outer component and acetabulum due to an impingement of the femoral neck on the liner and structural difference between the inner and outer joint.