Mid-Term Survivorship And Functional Outcome Of Austin Moore And Bipolar Hemiarthroplasty In Patients With Femoral Neck Fractures

Abstract

Objective: To analyze outcomes and 5 year survivorship differences between Austin Moore (AMP) and bipolar hip hemiarthroplasty in our institution.

Material and Methods: A retrospective study was carried out including 371 patients with displaced intra-capsular neck of femur fractures who underwent Austin Moore Prosthesis (AMP) or bipolar hemiarthroplasty (BHA) after written and informed consent, in Liaquat National Hospital from 2012 to 2016. Patients were followed after 5 years. In both groups differences in gender, comorbidities, ASA scores, operating time, intraoperative blood loss, ambulatory ability or postoperative morbidity and mortality and revision surgery between the two groups were also assessed. Kaplan–Meier curves were used for survivorship analysis and data were analyzed using SPSS version 26.

Results: Between 2012-2016, a total of 371 patients underwent AMP and bipolar hemiarthroplasty in our setup, they were divided in 2 groups, after excluding the patients who were lost to follow-up or passed away, the total number of patients remaining were 76 (36 patients in AMP group and 40 patients in BHA group). The mean age in BHA group was 63.4 (± 9.3) and in AMP group 66.3 (± 10.9). Patients who achieved independent community ambulatory status in bipolar group was 70% and 33.3 % in AMP group, which was statically significant (P <0.05). Survivorship analysis was done using two end points (with 95 % confidence interval), mean time from surgery to independent ambulatory status was 5 (±0.6) weeks and 7 (±0.7) weeks in bipolar and unipolar hemiarthroplasty respectively which shows significant difference.

Conclusions: Patients who underwent bipolar hemiarthroplasty had a more satisfactory outcome in terms of early independent ambulation in comparison with those who underwent Austin moore prosthesis. Although there was significantly less blood loss and operating time in unipolar hemiarthroplasty, the ambulatory ability was significantly better in bipolar hemiarthroplasty group.