การรักษาผู้ป่วยคอกระดูกสะโพกหักในผู้สูงอายุด้วยวิธีผ่าตัดเปลี่ยนข้อสะโพก Total hip arthroplasty ต่อระยะเวลานอนโรงพยาบาล เมื่อเทียบกับ Bipolar hemiarthroplasty

Soarawit Weerasopone; Kullaya  Weerasopone; Meechai  Preechapolasith; Thanasak  Yakumpor

Authors

Soarawit Weerasopone Department of Orthopedics, Faculty of Medicine, Burapha University, Chonburi Thailand
Kullaya Weerasopone Department of Physical Medicine and Rehabilitation, Queen Savang Vadhana Memorial hospital, Si Racha District, Chonburi, Thailand
Meechai Preechapolasith Department of Orthopedics, Samitivej Chonburi hospital, Si Racha District, Chonburi, Thailand
Thanasak Yakumpor Department of Orthopedics, Faculty of Medicine, Burapha University, Chonburi Thailand

Keywords:

Elderly, Femoral neck fracture, Bipolar hemiarthroplasty, Total hip arthroplasty, Length of stay

Abstract

Introduction: Femoral neck fractures in the elderly are a critical impairment due to their association with high mortality and disability rates. Bipolar Hemiarthroplasty (BH) and Total Hip Arthroplasty (THA) are the standard surgical interventions for femoral neck fractures. Typically,
BH is selected for patients with a higher comorbidity burden, whereas THA is preferred for younger, more active patients.

Objective: To compare the mean length of hospital stay (LOS), hospital costs, and postoperative complications between elderly patients treated with BH and THA.

Methods: This retrospective comparative study analyzed data from 98 patients at Burapha University Hospital from July 2017 to December 2023. Baseline characteristics, LOS, costs, and complications were evaluated.

Results: The BH group was significantly older and had a higher comorbidity burden than the THA group. No significant difference was found in LOS between BH (13.98 ± 9.75 days) and THA (13.33 ± 8.31 days) (p = 0.722). However, BH was associated with significantly lower hospital
costs (122,012 vs. 149,275 THB; p = 0.004) and shorter operative time (p < 0.001). Furthermore, the BH group presented more complications compared to the THA group (9 vs. 5 cases).

Conclusion: While BH does not significantly reduce the length of hospital stay as compared with THA, the procedure does offer lower treatment costs. The increased complication rate in the BH group likely reflects the patients’ underlying health conditions rather than the surgical
technique itself.

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