Early clinical results of cementless, bipolar hemiarthroplasty in intracapsular femur neck fractures

Objectives: In this study we report our initial experience with the use of cementless, bipolar hemiarthroplasty in elderly patients with intracapsular femur neck fractures. Patients and methods: We operated 67 consecutive patients (39 females, 28 males; mean age 74.4 +/- 11.0 years; range 41 to 99 years) who admitted to our clinic June 2007 and November 2009, due to intracapsular femur neck fracture and implanted cementless, rectangular, dual-taper, straight femoral stem (Zweymuller stem) with bipolar head prosthesis. All patients were allowed to full weight bearing with a walker within the first postoperative 48 hours. Results: According to the Garden's classification, there were nine type II, 53 type III and five type IV fractures. Twelve patients were lost to follow-up and 21 deceased during the postoperative follow-up period. Among 34 patients with complete follow-up, 30 were evaluated for the clinical outcome. The mean follow-up time and Harris hip score of the evaluated patients were 19.4 months and 79.4 points, respectively. It was seen that, the patient age significantly correlated with the clinical outcome and a better mean hip score was obtained in the "70 years and younger age group" (83.6 points) as compared to the "older than 70 years age group" (75.6 points) (p=0.014). Mortality rate was found to be higher in patients older than 70 years (47% vs. 18%; p=0.036) and with displaced fractures (45% vs. 0%; p=0.018). Conclusion: Zweymuller cementless bipolar hemiarthroplasty may be an alternative treatment method for intracapsular femur neck fractures especially in the patients under the age of 70 years.