Abstract:Objective To compare clinical efficacy and cost-effectiveness in treatment of femoral neck fracture with total hip arthroplasty(THA) and bipolar hemiarthroplasty(BHA) in elderly.Methods 169 patients over 70 years old with femoral neck fractures were treated with either THA or BHA.Comparison between THA and BHA groups were carried out on operation duration,incision size,blood loss,postoperative drainage,transfusion volume,average length of hospital stay,average cost,complication rate,hip function(Harris scores) and X-ray assessment.Results The patients were followed up for 2 years to 5.7 years,with an average follow-up period of 5.1 years.The operation duration,amounts of blood loss,postoperative drainage,blood transfusion,postoperative dislocation rate and average cost of THA group were greater than those of BHA group(P<0.05,respectively).Differences of average length of hospitalization,incision size,postoperative Harris scores,incidence of complications and infection rates between the two groups were not significant(P>0.05,respectively).In the patients over 75 years old,there were not significant differences on Harris scores 2 and 5 years post-operation and mortality between the two groups(P>0.05,respectively).The Harris scores at 0.5 years post-operation of BHA group was higher than that of THA group(P<0.05).Conclusion The clinical efficacy of BHA at mid-term was similar to that of THA in treatment of femoral neck fracture in elderly.However,BHA may be more suitable for patients who are frail and with complications because of it’s advantage in less surgical trauma and risks,quicker recovery and lower cost than THA.
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