Outcomes Comparison in the Management of Displaced Femoral Neck Fractures among Elderly Patients: Total Hip Arthroplasty versus Bipolar Hemiarthroplasty Hip Arthroplasty Outcomes in Displaced Femoral Neck Fractures

Main Article Content

Somchai Taosuwan
Varah Yuenyongviwat

Abstract

Treating femoral neck fractures in the elderly demands careful strategies for optimal results. This review explores into the roles of total hip arthroplasty (THA) and bipolar hemiarthroplasty (BHA) in addressing these fractures, considering their distinct advantages. THA, catering to active elderly patients, delivers excellent pain relief, enhanced mobility, and sustained functionality. In contrast, BHA presents a more conservative option suitable for less mobile patients. Factors like surgery time and dislocation risks play a crucial role in selecting between the two options, while postoperative complications, including infections and joint issues, significantly impact recovery. Adequate post-surgical care and advancements in techniques are pivotal for overcoming these challenges. Continuous research and enhancements in diagnostic methods and post-surgical care are critical for refining strategies, ultimately improving the recovery and quality of life for elderly patients.

Article Details

How to Cite
Taosuwan, S., & Yuenyongviwat, V. (2024). Outcomes Comparison in the Management of Displaced Femoral Neck Fractures among Elderly Patients: Total Hip Arthroplasty versus Bipolar Hemiarthroplasty: Hip Arthroplasty Outcomes in Displaced Femoral Neck Fractures. Vajira Medical Journal : Journal of Urban Medicine, 68(1), e266094. https://doi.org/10.62691/vmj.2024.266094
Section
Review Articles
Author Biography

Varah Yuenyongviwat, Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand

 

 

References

Kannus P, Parkkari J, Sievänen H, Heinonen A, Vuori I, Järvinen M. Epidemiology of hip fractures. Bone 1996;18(1 Suppl):57S-63S.

National Institute for Health and Care Excellence. Hip fracture: management. NICE clinical guidelines [internet]. 2023[cited 2023 Oct 26]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553768/

Deleanu B, Prejbeanu R, Tsiridis E, Vermesan D, Crisan D, Haragus H, et al. Occult fractures of the proximal femur: imaging diagnosis and management of 82 cases in a regional trauma center. World J Emerg Surg 2015;10:55.

Foex BA, Russell A. BET 2: CT versus MRI for occult hip fractures. Emerg Med J 2018;35(10):645-7.

Lewis SR, Macey R, Lewis J, Stokes J, Gill JR, Cook JA, et al. Surgical interventions for treating extracapsular hip fractures in older adults: a network meta-analysis. Cochrane Database Syst Rev 2022;2(2):CD013405.

Stirton JB, Maier JC, Nandi S. Total hip arthroplasty for the management of hip fracture: a review of the literature. J Orthop 2019;16(2):141-4.

Frihagen F, Nordsletten L, Madsen JE. Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trial. BMJ 2007;335(7632):1251-4.

Chammout GK, Mukka SS, Carlsson T, Neander GF, Stark AW, Skoldenberg OG. Total hip replacement versus open reduction and internal fixation of displaced femoral neck fractures: a randomized long-term follow-up study. J Bone Joint Surg Am 2012;94(21):1921-8.

Rogmark C, Carlsson A, Johnell O, Sernbo I. A prospective randomised trial of internal fixation versus arthroplasty for displaced fractures of the neck of the femur. Functional outcome for 450 patients at two years. J Bone Joint Surg Br 2002;84(2):183-8.

Schuetze K, Burkhardt J, Pankratz C, Eickhoff A, Boehringer A, Degenhart C, et al. Is new always better: comparison of the femoral neck system and the dynamic hip screw in the treatment of femoral neck fractures. Arch Orthop Trauma Surg 2023; 143(6):3155-61.

Kazley JM, Banerjee S, Abousayed MM, Rosenbaum AJ. Classifications in brief: garden classification of femoral neck fractures. Clin Orthop Relat Res 2018;476(2):441-5.

Emmerson BR, Varacallo M, Inman D. Hip Fracture Overview [internet]. 2023[updated 2023 Aug; cited 2023 Oct 26]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557514/

Florschutz AV, Langford JR, Haidukewych GJ, Koval KJ. Femoral neck fractures: current management. J Orthop Trauma 2015;29(3):121-9.

Zhang LZ, Gao J, Zhang ZC, Wang XW, Zhang JZ, Sun TS. Comparison of clinical effects of total artificial hip replacement and cannulated screw fixation for the treatment of displaced femoral neck fractures in elderly patients. Zhongguo Gu Shang 2018;31(2):103-10.

Lutnick E, Kang J, Freccero DM. Surgical treatment of femoral neck fractures: a brief review. Geriatrics (Basel) 2020;5(2):22.

Choudhary BM, Ram GG. Bipolar hemiarthroplasty versus total hip replacement in displaced femoral neck fracture in elderly. Surg Rev: Int J Surg, Trauma Orthop 2020;6(2):105-9.

Bhandari M, Einhorn TA, Guyatt G, Schemitsch EH, Zura RD, Sprague S, et al. Total hip arthroplasty or hemiarthroplasty for hip fracture. N Engl J Med 2019;381(23):2199-208.

Migliorini F, Maffulli N, Trivellas M, Eschweiler J, Hildebrand F, Betsch M. Total hip arthroplasty compared to bipolar and unipolar hemiarthroplasty for displaced hip fractures in the elderly: a Bayesian network meta-analysis. Eur J Trauma Emerg Surg 2022;48(4):2655-66.

Muslim SM, Lingayat MB, Bansode P, Kesharwani A. Comparative outcome assessment of total hip arthroplasty versus bipolar hemiarthroplasty in intracapsular neck of femur fracture in old age. Int J Res Orthop 2023;9(5):956-61.

Rogmark C, Leonardsson O. Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients. Bone Joint J 2016;98-B(3):291-7.

Lombardi B, Paci M, Nannetti L, Moretti S, Maritato M, Benelli G. Total hip arthroplasty after hip fracture or osteoarthritis: are there differences in characteristics and outcomes in the early rehabilitative stage? Orthop Nurs 2014;33(1):43-7.

Fusheng X, Rongjun K, Yongfu G, Wei Q. Bipolar hemiarthroplasty vs. total hip replacement in elderly. Int J Clin Exp Med 2017;10(5):7911-20.

Istianah U, Nurjannah I, Magetsari R. Post-discharge complications in postoperative patients with hip fracture. J Clin Orthop Trauma 2020;14:8-13.

Carpintero P, Caeiro JR, Carpintero R, Morales A, Silva S, Mesa M. Complications of hip fractures: a review. World J Orthop 2014;5(4):402-11.

Farey JE, Cuthbert AR, Adie S, Harris IA. Bipolar hemiarthroplasty does not result in a higher risk of revision compared with total hip arthroplasty for displaced femoral neck fractures: an instrumental variable analysis of 36,118 procedures from the Australian Orthopaedic Association National Joint Replacement Registry. J Bone Joint Surg Am 2022;104(10):919-27.

Monzon DG, Iserson KV, Jauregui J, Musso C, Piccaluga F, Buttaro M. Total hip arthroplasty for hip fractures. Geriatr Orthop Surg Rehabil 2014;5(1):3–8.

Istianah U, Nurjannah I, Magetsari R. Post-discharge complications in postoperative patients with hip fracture. J Clin Orthop Trauma 2021;14:8–13.

Guyen O. Hemiarthroplasty or total hip arthroplasty in recent femoral neck fractures? Orthop Traumatol Surg Res 2019;105(1S):S95-101.

Melloh M, Eggli S, Busato A, Roder C. Predictors of early stem loosening after total hip arthroplasty: a case-control study. J Orthop Surg (Hong Kong) 2011;19(3):269-73.

Rysinska A, Sköldenberg O, Garland A, Rolfson O, Aspberg S, Eisler T, et al. Aseptic loosening after total hip arthroplasty and the risk of cardiovascular disease: a nested case-control study. PLoS One 2018;13(11):e0204391.

Roche JJ, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ 2005;331(7529):1374.