Total hip replacement versus bipolar femoral head replacement for femoral neck fractures in the elderly: effect on surgical indices, hip function, and postoperative complications.

OBJECTIVE

To comparatively assess the effects of total hip replacement (THA) versus bipolar femoral head replacement (BFHR) on surgical indices, hip function, and postoperative complications (POCs) in elderly patients with femoral neck fractures (FNFs).

METHODS

A total of 135 elderly patients with FNF were enrolled and assigned to a BFHR group (n=65) receiving BFHR and a THA group (n=70) undergoing THA. Comparative analyses were conducted on surgical indices, postoperative recovery, Harris Hip scale, Barthel index, stress-related biomarkers, inflammatory markers, incidence of POCs, and quality of life (Generic Quality of Life Inventory-74 [GQOLI-74]).

RESULTS

Compared to the BFHR group, the THA group exhibited significantly higher values in several surgery- and recovery-associated indices. THA-treated patients achieved higher postoperative Harris Hip scores, Barthel Index scores, and GQOLI-74 scores. Additionally, stress- and inflammation-related indices, as well as the overall incidence of POC, were markedly reduced in the THA group.

CONCLUSION

BFHR is characterized by minimal invasiveness, shorter operative time, and rapid postoperative recovery in FNF treatment among the elderly. In contrast, THA demonstrates superior clinical advantages in improving hip joint function, activities of daily living, and quality of life, along with more effective inhibition of postoperative stress and inflammation, and a lower POC risk.