Proximally coated cementless bipolar hemiarthroplasty in Dorr type C bone

The current study was conducted to examine the clinical and radiographic outcomes of cementless bipolar arthroplasty in patients who had type C bone at the time of the procedure. A total of 87 patients (105 hips) who had type C femora and had undergone cementless bipolar hemiarthroplasty with a proximally coated cementless prosthesis for the treatment of displaced femoral neck fractures at a single institution were reviewed. Patients included 83 women and 4 men who had a mean age of 84 years (range, 72-100 years) and were followed for a mean of 6 years (range, 2-11 years). Outcomes evaluated included aseptic implant survivorship, surgical complications, Harris Hip scores, and radiographic findings. At final follow-up, there were no revisions for aseptic implant loosening. The overall aseptic implant survivorship was 95%, with 5 patients undergoing revision surgery for aseptic reasons. Three revisions were because of periprosthetic fractures after falls, 1 revision was because of intractable groin pain, and 1 revision was because of recurrent dislocations. The surgical complication rate was 8.5%, which included 3 septic revisions, 2 avulsion fractures of the greater trochanter after falls, 2 superficial wound infections, 1 recurrent dislocation, and 1 wound hematoma. The mean Harris Hip score had improved to 80 points (range, 30-97 points) at final follow-up. Despite generally poor bone quality and medical comorbidities, elderly patients with displaced femoral neck fractures achieved excellent clinical outcomes, with few perioperative complications, through the use of proximally coated cementless bipolar hemiarthroplasty.