Total Hip Arthroplasty versus Bipolar Hemiarthroplasty as a Treatment for Intracapsular Hip Fractures in the Elderly

Background: intracapsular hip fractures are a common problem that we face in the health system in the elderly population. Many complications can develop if these fractures are not treated in time. Due to the fact that this population usually suffers from other comorbidities which may lead to anesthetic complications as well, our purpose is to give these patients a "one shot" surgery, and to reduce the rate of revision surgeries which entails higher rate of complications.

Methods: we collected data from total hip arthroplasty and bipolar hemiarthroplasty which were performed in Soroka medical center during the years 2015-2016. A total of 104 cases of bipolar hemiarthroplasty and 166 cases of total hip arthroplasty were included in this study. The main outcome was postoperative complications which included wound infection and dislocations. Secondary outcomes were average of days until release from the hospital and if the patient was released home or to a rehabilitation facility.

Results: in the bipolar hemiarthroplasty group 6 cases of wound infection were observed (5.7%) and 9 cases of dislocation (8.6%). In the total hip arthroplasty group 2 cases of wound infection and 2 cases of dislocation were observed (1.2%). Average postoperative hospital stay was shorter in total hip arthroplasty and more patients were released home compared to bipolar hemiarthroplasty group.