• Franz Müller, Bernd Füchtmeier, Axel Probst, and Ronny Langenhan.
• Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder Regensburg, Germany. Electronic address: franz.mueller@barmherzige-regensburg.de.
• Injury. 2021 Oct 1; 52 (10): 2991-2996.

BackgroundThis study aimed to evaluate the outcome of unipolar and bipolar hemiarthroplasty to treat hip fractures in patients aged ≥ 90 years.MethodsWe conducted this study from 2007 to 2018 based on the electronic databases of two hospitals. Patients aged ≥ 90 years, treated for Arbeitsgemeinschaft Osteosynthese 31-B3 type fractures, were included. One hospital conducted the treatment only with unipolar prostheses; the other hospital used only bipolar prostheses. We assessed 23 peri‑ and postoperative variables including any revision, dislocation, and survival. The follow-up was completed after a minimum of 2 years postoperatively. At follow-up, the functional status was evaluated via telephone using the Parker score for every living patient.ResultsOne-hundred unipolar prostheses, and 109 bipolar prostheses were examined. The patients' mean age was 92.9 years (range 90-102). Dementia was differently distributed between the groups (p < 0.001), with a lower survival risk (Odds Ratio 1.908; Confidence Interval 1.392 - 2.615; log rank <0.001). Based on this result, unipolar demonstrated significantly higher mortality rates compared with bipolar prostheses (log rank < 0.001). No effects were found for dislocation, revision and overall complication rate. At follow-up, 37 patients were available for functional status. The mean Parker score was 3.7 (range 0-9), with no effect.ConclusionsIntracapsular hip fractures in patients aged ≥ 90 years can be treated with unipolar or bipolar hemiarthroplasty. The type of prostheses did not influence dislocation, revision, general complication, or functional status. The groups were significantly affected by dementia, a risk factor for shorter survival.Copyright © 2021. Published by Elsevier Ltd.

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