[Translated article] Uncemented bipolar arthroplasty in extracapsular hip fracture in elderly patients

Extracapsular hip fractures in patients over 85 years old represent a therapeutic challenge due to their high vulnerability and risk of complications. This study analyzes the efficacy and safety of bipolar hip arthroplasty with uncemented femoral stems in this population.

A retrospective study was conducted at three referral hospitals, including 63 patients over 85 years old treated between 2019 and 2023. Clinical, radiological, and functional variables were evaluated with a minimum follow-up of 12 months. Hip function was assessed using the Harris Hip Score (HHS).

The mean age was 86.7 years, with a female predominance (63.5%). The average surgical time was 46±7min, and intraoperative blood loss was 220±40ml. The complication rate was low: 14.2% experienced mild hypotension, 1.6% suffered a periprosthetic fracture, and isolated cases of postoperative hyperglycemia and hypoalbuminemia were promptly resolved. The mean HHS was 79±8 points at 6 months and 81±6 points at 12 months. A total of 71.4% of patients regained their pre-injury ambulatory status. No significant prosthetic subsidence or femoral pain was observed.

Bipolar hip arthroplasty with uncemented femoral stems appears to be a safe and effective option for treating extracapsular hip fractures in patients over 85 years old, allowing early rehabilitation and reducing complications associated with cementation and osteosynthesis.