Cemented bipolar hemiarthroplasty for displaced intracapsular fracture in the mobile active elderly patient

Fifty-three patients who were independently mobile outside their home at the time of a displaced intracapsular fractured neck of femur were reviewed at a mean follow-up of 32 months after treatment with a cemented bipolar hemiarthroplasty. Forty-four had no or mild pain. Eleven of the sixteen able to walk 1 mile before fracture were able to do so at review, once significant co-morbidity was excluded. There were no dislocations. Two had been revised, one for technical failure. These results are significantly better than would be expected with conventional hemiarthroplasty in this group of patients. They are comparable with results of total hip replacement (THR) but without the risk of dislocation. Patients able to walk 1 mile before fracture regained their pre-fracture mobility significantly better than those able to walk 500 yards. We suggest that ability to walk 1 mile should define the mobile active elderly for future studies and in guiding treatment.