A comparative study between hemiarthroplasty with bone cement and hemiarthroplasty with bone graft impaction for treatment of fracture neck femur in elderly patients

Rakesh Kumar; Anand Shankar; Rishabh Kumar; Ashutosh Kumar

doi:10.18203/2320-6012.ijrms20242276

Authors

Rakesh Kumar Department of Trauma and Emergency, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
Anand Shankar Department of Trauma and Emergency, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
Rishabh Kumar Department of Trauma and Emergency, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
Ashutosh Kumar Department of Trauma and Emergency, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20242276

Keywords:

Bone graft, Cemented graft, Bipolar, Partial hip replacement

Abstract

Background: The effectiveness of cementing and graft during hemiarthroplasty for fracture neck of femur in elderly individuals is debatable. Although cementing provides an excellent initial fix, there is incidence of hypotension during surgery. On the other hand, periprosthetic fractures have been linked with high costs. A femoral head can provide an autologous bone graft to fill the femoral bone's medullary cavity, lowering complications related to cemented bipolar hemiarthroplasty.

Methods: At Indira Gandhi institute of medical sciences, Patna a prospective study was carried out from April 2021 to March 2023. The study comprised patients who had fractured their neck femurs. Patients were separated into two groups of 30 each. Group A had bipolar partial hip replacement using the femoral head as a graft, while group B had cemented bipolar partial hip replacement. Functional outcomes were contrasted between 2 groups.

Results: After a year, 22 of the patients (73.3%) in the bone graft group had excellent outcomes, while 8 (26.6%) had favorable outcomes. Within group B (Cementing group), ten individuals (33.3%) had outstanding results, ten individuals (33.3%) had good outcomes, eight individuals (26.6%) had satisfactory results, and two individuals (6.6%) had bad outcomes. The findings were statistically significant (p<0.05). The practical outcome of cementing bipolar versus one’s with bipolar bone graft differed significantly.

Conclusions: A procedure called bipolar partial hip replacement with the femoral head used as a graft of bone is a superior choice to surgery for fracture neck-femur in elderly people compared to cemented bipolar partial hip replacement.

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