Cemented Thompson versus cemented bipolar prostheses for femoral neck fractures.
OBJECTIVE
To compare early functional outcomes, complications, and mortality in elderly patients treated with the less costly, cemented Thompson prosthesis or the cemented bipolar prosthesis in order to identify factors affecting outcomes.


METHODS
Records of 303 patients with femoral neck fractures treated with the cemented Thompson monoblock prosthesis (n=206) or the cemented bipolar prosthesis (n=97) were reviewed. The choice of prosthesis was solely determined by surgeon's preference. Data relating to patient demographics, clinical and residential status, mobility, mental function, mortality, and complications during hospitalisation and rehabilitation were collected.


RESULTS
After adjusting for confounding variables, independent postoperative indoor mobility was associated with preoperative indoor mobility (p=0.002) and mental function (p=0.001), whereas postoperative outdoor mobility was associated with preoperative outdoor mobility (p=0.003), daily living activity (p=0.02), and mental function (p=0.02). Mortality within 6 months was only associated with poor mental function (p=0.009). At 6-month follow-up, there was no significant difference between the 2 types of prosthesis in terms of functional outcomes, mortality and complication rates.


CONCLUSIONS
In elderly patients with limited mobility, treatment with the bipolar prosthesis was not associated with better short-term outcomes than those receiving the Thompson prosthesis.
Bauer
Stefan
S
Department of Orthopaedic and Trauma Surgery, Royal Perth Hospital, Perth, Western Australia, Australia. stef11bau@yahoo.co.uk
Isenegger
Patrick
P
Gautschi
Oliver P
OP
Ho
Kwok M
KM
Yates
Piers J
PJ
Zellweger
Rene
R
D000369:Aged, 80 and over; D001843:Bone Cements; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D006621:Hip Joint / Q000503:physiopathology; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D001843:Bone Cements