Proximally coated cementless bipolar hemiarthroplasty in Dorr type C bone

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Biomaterials Engineering

Background:

• Displaced femoral neck fractures are common in elderly patients, often with poor bone quality (Type C bone).
• Traditional treatments may have limitations in this patient population.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of cementless bipolar arthroplasty in elderly patients with Type C femoral bone undergoing treatment for displaced femoral neck fractures.

Main Methods:

• Retrospective review of 87 patients (105 hips) with Type C femora who underwent cementless bipolar hemiarthroplasty.
• Prostheses used were proximally coated and cementless.
• Outcomes assessed included aseptic implant survivorship, surgical complications, Harris Hip scores, and radiographic findings over a mean 6-year follow-up.

Main Results:

• Overall aseptic implant survivorship was 95%, with no revisions for aseptic loosening.
• Five patients required revision surgery for aseptic reasons (periprosthetic fractures, groin pain, dislocations).
• The surgical complication rate was 8.5%, including septic revisions, trochanteric fractures, and wound infections. Mean Harris Hip score improved to 80.

Conclusions:

• Cementless bipolar arthroplasty with proximally coated implants provides excellent clinical outcomes for elderly patients with displaced femoral neck fractures and poor bone quality.
• The procedure is associated with a low rate of aseptic loosening and manageable perioperative complications.
• This surgical approach offers a viable option for improving function and quality of life in this challenging patient group.