[Perioperative outcomes of bipolar hip arthroplasty in patients aged over 80 with medial femoral neck fractures].

Introduction

Hip fractures are common among the older and oldest-old population. A significant portion of these injuries are medial femoral neck fractures, which are primarily treated surgically. In elderly patients, joint replacement techniques are generally preferred to enable the fastest possible restoration of mobility. Materials and methods: In this study, we retrospectively evaluated the perioperative data of 229 patients who underwent bipolar hemiarthroplasty due to medial femoral neck fractures. During follow-up, we paid particular attention to the patients’ hemoglobin levels and assessed perioperative complications.

Results

Surgical intervention was performed within 24 hours in 76.5% of the patients, while treatment was delayed beyond 48 hours for only 7 cases. General perioperative complications occurred in 73 patients (31.9%). The occurrence of complications was independent of gender, age, implant fixation method, timing of the intervention, or duration of the procedure. However, no significant association was observed between the severity of complications and anticoagulant therapy. Additionally, we found a significant correlation between complications and dementia, as well as the timing of surgical treatment. Furthermore, while 55.9% of patients received oral anticoagulant therapy, 24.9% required blood transfusion. The need for transfusion was clearly associated with the use of anticoagulant medications (p = 0.022), the use of cemented implants (p = 0.005), and the duration of the surgical procedure (p = 0.001). Discussion: In the treatment of older and oldest-old patients – who often suffer from multiple comorbidities and medial femoral neck fractures – it is especially important to perform surgery as early and as gently as possible, to facilitate rapid mobilization and reduce complications. From a surgical perspective, bipolar hemiarthroplasty is a procedure that can be performed quickly and with good results.

Conclusion

Because early surgical treatment is often delayed by the patients’ use of anticoagulant medications. Therefore, in addition to timely surgical intervention, proper hemoglobin management and the parallel treatment of comorbidities are crucial to minimize perioperative complications. In this regard, the early involvement of a geriatric specialist can provide significant support in the overall care process. Orv Hetil. 2025; 166(39): 1538–1548.