Bipolar Hemiarthroplasty for Unstable Intertrochanteric Femur Fracture in Patients over the Age of 80 Years: Comparative Analysis between Cementless and Cemented Stem

With today’s aging population, musculoskeletal diseases such as osteoporosis, degenerative arthritis, and degenerative spine disease, are on the rise, and these conditions are associated with increased fracture risk. Intertrochanteric fractures in elderly patients often involve severe displacement or comminution with poor bone quality. Accordingly, various treatment methods for hip fracture have been introduced. The incidence of fixation failure is reported to be as high as 20% in unstable intertrochanteric fracture due to nonunion, metal failure, and femoral perforation. Also postoperative ambulation may be delayed in this population due to the difficulty of achieving firm fixation. In addition, when fixation failure happens, reoperation may not be possible due to the patient’s general condition and medical complications. In comparison, bipolar hemiarthroplasty is performed as an alternative to osteosynthesis in elderly patients with unstable fracture patterns regardless of bone quality, and early ambulation is possible if stable fixation is attained. In cases of poor bone quality, cemented fixation was used in the past to enhance the initial fixation strength. A cemented stem is advantageous for stable fixation, early weight bearing, and less thigh pain, but it increases the operation time and blood loss, and complications such as cardiovascular toxicity. In the past, cementless fixation was not favored because it led to problems with initial fixation strength, bone ingrowth, subsidence of the stem and intraoperative periprosthetic fracture. However, with improvements in implant design, material, pISSN : 1226-2102, eISSN : 2005-8918 483