Objective: There are various Surgical methods for treatment of avascular necrosis of femoral head like core decompression, vascular and avascular bone grafting, osteotomies, hemiarthroplasty, total hip replacement and arthrodesis. The aim of this prospective study was to evaluate the Outcomes of Bipolar Hemiarthroplasty in Young Adults as Treatment of Avascular Necrosis of Femoral Head.

Patients & Method: This prospective study was conducted on 25 relatively young male adults with mean age of 39 years (range 28 to 59 yaers). Approximately all the patients were of avascular necrosis of femoral head with nearly normal acetabulum. Superficial smoothening of the acetabulum was also performed in few cases. Snug fitting of the trial cups was confirmed and care was taken that there is no gross movement between outer cup and acetabulum. We believe that Bipolar prosthesis is easy to implant and can be done in the above age group instead of conventional hemiarthroplasty and more extensive surgery like total hip replacement. Due to double mobility it protects the acetabular cartilage for a quite long time with the increased range of motion in the hip joint. Clinical follow up was done by using Harris hip score (HHS) system.

Results: All patients, were regularly followed up and longest follow up is 3 years in five patients and shortest follow is three months in three patients. The HHS significantly improved from a preoperative value of 39.3 (range, 54-30) to a postoperative value of 89.12 (range 74-96). According to HHS grades, the final outcome was excellent in 14 hips, good in 8 and fair in 3 hips. Complications seen were wound infection in one case.

Conclusion: Bipolar hemiarthroplasty with tight fitting cup for avascular necrosis of femur neck has a very low chances of groin pain, erosion of acetabulam, and revision during follow up

Keywords: Femoral head, avascular necrosis, bipolar hemiarthroplasty.

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Dr Bijayendra Nath Chaturvedi

Senior Resident, Department of Orthopaedics, Nalanda Medical College & Hospital, Patna