Does a bipolar hemiprosthesis offer advantages for elderly patients with neck of femur fracture? A clinical trial with 261 patients

Abstract

These short-term results suggest that unipolar implants share many of the advantages of the bipolar prosthesis but can be manufactured at substantially lower cost. These implants may be appropriate for the less-active elderly patient, particularly when used with bone cement.

Meta-analysis of randomised controlled trials comparing unipolar with bipolar hemiarthroplasty for displaced femoral-neck fractures

“…Our search strategy found 107 articles; nine studies [9][10][11][12][13][14][15][16][17] involving 1,100 patients met inclusion criteria (Fig. 1).…”

“…Table 2 summarises study methodological quality and characteristics. All nine studies were randomised, and six [9][10][11][12][13]16] had adequate randomisation procedures; Seven had concealed allocation, and two [16,17] did not. Six studies used blinding, and three [9,15,17] did not.…”

“…Second, seven RCTs were identified in their study, two of which were only reported as a conference abstract with no data; eventually, only five were included for the final analysis. Therefore, that report should be updated, as a number of new, well-designed RCTs [13][14][15][16] have since been published. Compared with the Cochrane report, we included four other studies [13][14][15][16] and excluded that reported no data.…”

“…Dislocation rates were available in seven studies (1,049 patients, 18 events) [9][10][11][12][15][16][17]. Pooled data showed 521 bipolar and 528 unipolar HA (re-operations were ten and eight cases, respectively).…”

“…Numerous studies [9][10][11][12][13][14][15][16][17] have compared clinical results of bipolar with unipolar HA. In a long-term follow-up trial comparing bipolar with unipolar prostheses, LaBelle et al [7] found there was less pain and decreased acetabular protrusion in the bipolar group.…”