Vol. 9 | Issue 1 | January-February 2021 | Page: 36-40 | Prashanth Dhanraj, Eshwar patel, Harish Kodi, Lokesh Gupta, Sunkoj Krishna sai
Authors: Prashanth Dhanraj , Eshwar patel , Harish Kodi , Lokesh Gupta , Sunkoj Krishna sai 
 Department of Orthopaedics, Kamineni Institute of medical sciences, Telangana, India.
Address of Correspondence
Dr. Prashanth Dhanraj
Assistant Professor, Department of Orthopaedics, Kamineni Institute of medical sciences, Telangana, India.
Background: Fracture neck of the femur leads to significant morbidity and mortality in elderly population. Various surgical options are available for the treatment in the elderly, but the gold standard between Austin Moore’s prosthesis and bipolar prosthesis is always debated. Hence, we designed a short-term prospective study to compare the monopolar and bipolar hemiarthroplasty in the elderly having fracture neck of the femur.
Materials and Methods: We conducted a prospective study at a tertiary hospital between 2017 and 2019. In our study, we enrolled 30 patients in each group. Patients in Group A (monopolar) underwent Austin Moore’s hemiarthroplasty and in Group B (Bipolar) underwent uncemented bipolar hemiarthroplasty by standard posterolateral approach. Patients were treated by standard protocols and analyzed at regular intervals with final assessment done at the end of 1 year. Functional outcome was evaluated using Harris Hip Score.
Results: Out of total 60 patients, 51 were evaluated at the end of 1 year. Mean age of population was 66.58 ± 5.96 in monopolar and 64.68 ± 7.48 in bipolar group. Harris Hip Score was 86.58 ± 5.42 in monopolar and 88.52 ± 3.08 in bipolar group. Pain was 38.69 ± 3.58 in monopolar and 40.20 ± 1.50 in bipolar group. Functional status was 39.72 ± 3.00 in monopolar group and 39.58 ±3.45 in bipolar group. Excellent outcome was noted in 13 of monopolar and 15 of bipolar patients seven 7 complications in monopolar and six in bipolar group, respectively.
Conclusion: In our study, we had comparable functional (Harris Hip Score) results in the monopolar and bipolar prosthesis groups, though more excellent outcomes and less complications were encountered in the bipolar group than monopolar which is statistically insignificant at the end of 1 year.
Keywords: Austin Moore, Bipolar, Hemiarthroplasty, Monopolar, Neck of femur fracture, Hemireplacement.
1. 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:291-7.
2. Leonardsson O, Garellick G, Kärrholm J, Åkesson K, Rogmark C. Changes in implant choice and surgical technique for hemiarthroplasty: 21, 346 procedures from the Swedish hip arthroplasty register 2005-2009. Acta Orthop 2012;83:7-13.
3. Zhou Z, Yan F, Sha W, Wang L, Zhang X. Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures in elderly patients. Orthopedics 2015;38:697-702.
4. Wang F, Zhang H, Zhang Z, Ma C, Feng X. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: A meta-analysis. BMC Musculoskelet Disord 2015;16:229.
5. Liu Y, Tao X, Wang P, Zhang Z, Zhang W, Qi Q. Meta-analysis of randomised controlled trials comparing unipolar with bipolar hemiarthroplasty for displaced femoral-neck fractures. Int Orthop 2014;38:1691-6.
6. Haidukewych GJ, Berry DJ. Hip arthroplasty for salvage of failed treatment of intertrochanteric hip fractures. J Bone Joint Surg Am 2003;85:899-904.
7. Sabnis BM, Brenkel IJ. Unipolar versus bipolar uncemented hemiarthroplasty for elderly patients with displaced intracapsular femoral neck fractures. J Orthop Surg (Hong Kong) 2011;19:8-12.
8. Hedbeck CJ, Enocson A, Lapidus G, Blomfeldt R, Törnkvist H, Ponzer S, et al. Comparison of bipolar hemiarthroplasty with total hip arthroplasty for displaced femoral neck fractures: A concise four-year follow-up of a randomized trial. J Bone Joint Surg Am 2011;93:445-50.
9. Rodríguez-Merchán EC. Displaced intracapsular hip fractures: Hemiarthroplasty or total arthroplasty? Clin Orthop Relat Res 2002;399:72-7.
10. Alazzawi S, de Rover WB, Brown J, Davis B. The conversion rate of bipolar hemiarthroplasty after a hip fracture to a total hip arthroplasty. Clin Orthop Surg 2012;4:117-20.
11. Sharkey PF, Hozack J, Rothman H. Conversion of hemiarthroplasty to total hip arthroplasty: Can groin pain be eliminated? J Arthroplasty 1998;13:627-30.
12. Inngul C, Hedbeck CJ, Blomfeldt R, Lapidus G, Ponzer S, Enocson A. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures: A four-year follow-up of a randomised controlled trial. Int Orthop 2013;37:2457-64.
13. Somashekar, Krishna SV, Murthy JS. Treatment of femoral neck fractures: Unipolar versus bipolar hemiarthroplasty. Malays Orthop J 2013;7:6-11.
14. Enocson A, Hedbeck CJ, Törnkvist H, Tidermark J, Lapidus LJ. Unipolar versus bipolar Exeter hip hemiarthroplasty: A prospective cohort study on 830 consecutive hips in patients with femoral neck fractures. Int Orthop 2012;36:711-7.
15. Jia Z, Ding F, Wu Y, Li W, Li H, Wang D, et al. Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures: A systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2015;10:8.
16. Ayhan E, Kesmezacar H, Karaman O, Sahin A, Kir N. Bipolar or unipolar hemiarthroplasty after femoral neck fracture in the geriatric population. Balkam Med J 2013;30:400-5.
17. Jeffcote B, Li MG, Barnet‐Moorcroft A, Wood D, Nivbrant B. Roentgen stereophotogrammetric analysis and clinical assessment of unipolar versus bipolar hemiarthroplasty for subcapital femur fracture: A randomized prospective study. ANZ J Surg 2010;80:242-6.
18. Barnes CL, Berry DJ, Sledge CB. Dislocation after bipolar hemiarthroplasty of the hip. J Arthroplasty 1995;10:667-9.
19. Phillips T. The Bateman bipolar femoral head replacement. A fluoroscopic study of movement over a four-year period. J Bone Joint Surg Br 1987;69:761-4.
20. Varley J, Parker MJ. Stability of hip hemiarthroplasties. Int Orthop 2004;28:274-7.
21. Calder SJ, Anderson GH, Jagger C, Harper WM, Gregg PJ. Unipolar or bipolar prosthesis for displaced intracapsular hip fracture in octogenarians: A randomised prospective study. J Bone Joint Surg Br 1996;78:391-4.
22. Ong BC, Maurer SG, Aharonoff GB, Zuckerman JD, Koval KJ. Unipolar versus bipolar hemiarthroplasty: Functional outcome after femoral neck fracture at a minimum of thirty-six months of follow-up. J Orthop Trauma 2002;16:317-22.
23. Leonardsson O, Kärrholm J, Åkesson K, Garellick G, Rogmark C. Higher risk of reoperation for bipolar and uncemented hemiarthroplasty: 23, 509 procedures after femoral neck fractures from the Swedish hip arthroplasty register, 2005-2010. Acta Orthop 2012;83:459-66.
24. Calton TF, Fehring TK, Griffin WL, Mccoy TH. Failure of the polyethylene after bipolar hemiarthroplasty of the hip. A report of five cases. J Bone Joint Surg Am 1998;80:420-3.
25. Gilbert MS, Capozzi J. Unipolar or bipolar prosthesis for the displaced intracapsular hip fracture? An unanswered question. Clin Orthop Relat Res 1998;353:81-5.
26. Raia FJ, Chapman CB, Herrera MF, Schweppe MW, Michelsen CB, Rosenwasser MP. Unipolar or bipolar hemiarthroplasty for femoral neck fractures in the elderly? Clin Orthop Relat Res 2003;414:259-65.
27. Bhattacharyya T, Koval KJ. Unipolar versus bipolar hemiarthroplasty for femoral neck fractures: Is there a difference? J Orthop Trauma 2009;23:426-7.
|How to Cite this article: Dhanraj P, Patel E, Kodi H, Gupta L, Sai SK | Functional Outcome of Unipolar (Austin Moore’s) Versus Uncemented Bipolar Hemiarthroplasty of Hip at 1-Year Follow-up | Journal of Karnataka Orthopaedic Association | January-February 2021; 9(1): 36-40.