Bipolar Hemiartroplasty In The Treatment Of Hip Fracture: Are Special Centres Necessary For The Optimal Outcome?

Background and Aims: This study compares retrospectively clinical follow-up of 72 bipolar arthroplasties made either by specialist surgeons or residents.

Material and Methods: 72 patients with a life-expectancy of more than three years were selected to have bipolar arthroplasty for the treatment of femoral collum fracture at Tampere University Hospital district during 1993–1995. The average age of the patients was 70 (47–92) years. All patients were followed at least 4 years for mortality as well as primary and late complications. A group of 49 (68 %) patients could be followed more carefully by clinical examination, by questionaire or by phone.

Results: 20 (28 %) patients died during the first three years after surgery and four (6 %) patients were re-operated. The bare preoperative clinical estimation made by the senior consultant surgeon did not predict good enough the life expectancy of the patients. Four patients had been revised, all operated by a senior surgeon. There were no revisions among the patients operated by junior doctors. No statistical differences were found between the patients operated by junior or senior surgeons or between cemented and cementless prostheses in pain, walking distances, limping, getting in to a car, need of support or sitting in high or normal chair.

Conclusions: The bipolar arthroplasty was found to give reproducible results also when residents take the responsibility of hip fracture treatment.