Postoperative Weight-Bearing after Uncemented Bipolar Hemiarthroplasty for Femoral Neck Fractures in Geriatric Patients with Dementia

Abstract

Dementia and hip fractures are two crucial problems in the elderly and the associations of these pathologies increase substantial morbidity and mortality. 178 patients with dementia (average age 81.5 years) were operated with an uncemented bipolar prosthesis for a displaced femoral neck fracture. They started rehabilitation sessions in the immediate postoperative period and were divided into two groups: group 1 — partial weight-bearing for 72 cases — and group 2 — total weight-bearing for 106 cases. 17 patients were unable to walk and 6 died during hospitalization. 172 patients were discharged to a rehabilitation department (46.6%) or to their home with (31.9%) or without (21.5%) rehabilitation facilities. During follow-up, 103 out of 172 patients accepted a phone interview. After three months 55 patients had regained the pre-fracture level of independence (6 patients from group 1 and 49 patients from group 2; 81% were included in a rehabilitation program). The mortality at one year postoperative period was 26.21%; the majorities of these patients were included in group 1, were more than 80 years old and had more than 4 comorbidities (except dementia).

The authors concluded that, for patients undergoing uncemented bipolar HA, immediate total weight-bearing and discharging to a rehabilitation facility showed a better recovery and return to the pre-fracture level, as well as a better one-year survival rate.