Cemented versus Uncemented Bipolar Hemiarthroplasty for Displaced Femoral Neck Fractures in Elderly Patients: A Prospective Comparative Study

Background: Displaced neck fracture of the femur among the elderly patients is frequent because of osteoporosis and longer life expectancy. Although hemiarthroplasty is a more common process in order to allow early mobilization and pain relief, there is still controversy on the cemented versus uncemented types of fixation with cemented bearing more cardiopulmonary probability risks and uncemented handling more periprosthetic fractures. This paper is a comparison of clinical, surgical, and functional outcomes of bipolar hemiarthroplasty cemented and uncemented. Material and Methods: This was a prospective comparative study involving 30 patients aged above 55 with displaced neck fractures at the femur who were admitted to a tertiary care unit and between June 2022 and December 2024. The patients were randomly selected into 2 groups of 15 and cemented bipolar hemiarthroplasty (n=15) and uncemented bipolar hemiarthroplasty (n=15). The inclusion criteria were taken to be age over 55 years and surgical suitability; non-inclusion: medical unfitness, refusal to have surgery, and open fractures. The outcome measures were the time on the operating table, blood loss and transfusion needs, Harris Hip Score (HHS), ambulatory capacity, pain medication, residence, and complications. Results: The sample size was 14 men and 16 women (mean age 69 years) and the patients had comorbidities such as anemia (n=5) and type 2 diabetes mellitus (n=11). Uncemented hemiarthroplasty was less intra-operative time consuming, less intra-operative blood loss and fewer blood transfusions was adopted. There were similar results in HHS. There were no observed significant differences in the postoperative ability of walking, analgesic needs, or the place of residence. Both techniques had acceptable levels of complications. Conclusion: Cemented and uncemented bipolar hemiarthroplasty have positive functional results and reasonable complication scores in elderly patients with displaced neck fracture of the femur. Uncemented fixation has benefits in operating duration and blood loss; whereas cemented could be more stable in long-term fixation in a particular context. The efficacy of the technique should be assessed in larger studies to compare the methodology in diverse fracture patterns and in long-term outcome. Keywords: Femoral neck fracture, bipolar hemiarthroplasty, cemented hemiarthroplasty, uncemented hemiarthroplasty, elderly, Harris Hip Score, prospective study.