NON CEMENTED BIPOLAR HEMI-ARTHROPLASTY, SURGICALLY INTERVENED FOR GERIATRIC FRACTURES OF NECK OF FEMUR, THAT ARE DISPLACED: A PROSPECTIVE CASE SERIES STUDY.

Abstract

Fracture neck of femur which are displaced, do not nd a place in the elderly where the head can be preserved even if there is a surgical intervention. Fixation devices like the DHS have time and again failed to satisfactorily treat these fractures. It's here that the Bipolar Hemi Arthroplasty comes to us, as a very handy operative tool. The question is, whether or not the stem of the Bipolar, be cemented or not. The problems of cementation in the elderly carries the risk of BCIs – the bone cementing implantation Syndrome; which can at times be fatal. Cementation makes, future needed Total Hip Replacement, more difcult. In this prospective study of patients conducted at Chettinad Hospital and Research Institute, Kelambakkam, South India ; we have chosen an age group between 61 to 75 years, with an inclusion criterion satisfying type III or IV Garden, but also at the same time, be classiable, as a type A or type B DORR's classication. Our male to female ratio was 1:2 the mean age was 68.5 years and 93.3% (n=84) of patients undergoing un-cemented Hemi-Arthroplasty, when graded by HHS were either Excellent or Good. We had no Poor outcomes in our study. Our minimum follow up was for 12 months, with a mean follow up of 23.5 months. All our cases were done by the Southern Moore's approach, with an average duration of surgery at 82 minutes. The blood loss on an average was 285 ml and the average blood transfusion rate was at 1.8 units. The average post operative stay was for 12 days. From this short-term prospective study, we concluded that Un-Cemented Hemi-replacement Arthroplasty gives Good to Excellent clinico-functional outcomes. It also does not cause any hindrance, if future Total Hip Replacement, is required. Our complication rates were also manageable, with only about 6.7% (n=6) patients, needing revision surgery due to stem loosening.