Scientific Online Resource System

Scripta Scientifica Medica

Short-term results of hip endoprosthesis with hemiprosthesis after femoral neck fracture, maintaining joint lubrication in adult patients

Nikolay Kolarov, Ruslan Popstefanov


INTRODUCTION: Femoral neck fracture is one of the most common traumas in adult patients. Usually, the patients with such fractures present with many accompanying diseases, i. e. polymorbidity. The majority of intraarticular femoral neck fractures are indicated for primary hip joint alloplastic surgery. Despite the higher operational risk compared to osteosynthesis, this procedure is preferred for the treatment of femoral neck fractures in patients over 75 years of age.

The main aim of this study is to build-up optimal indications or guidelines for primary endoprosthesis with hemiprosthesis after femoral neck fractures and to justify the choice of an optimal hip hemiprosthetic implant.

MATERIALS AND METHODS: An one-year study assessed the therapeutic effectiveness of the elliptical monoarticular endoprosthetic head use compared to monoarticular spherical and biarticular spherical endoprosthetic head applications based on three groups of criteria: subjective, radiographic, and functional in 167 patients with hemiarthroplasty.

RESULTS: According to the criteria mentioned above, better therapeutic outcomes have been achieved with the use of the elliptical monoarticular endoprosthetic head. The results of the follow-up of these patients showed that up to the end of the first year after surgery, a progressive elevation in the Modified Harris Hip Score point system as well as a regression to the disappearance of spontaneous and provoked pain regardless of the endoprosthetic design was recorded. The visual analogue scale scores showed a natural decrease in pain sensation with the passing of time from the surgical intervention despite the increasing motor activity.

CONCLUSION: The primary hip joint hemialoplasty is indicated for femoral neck fractures, Garden III or IV, in polymorbid patients over 75 years of age. The elliptical monoarticular endoprosthetic head shows better therapeutic results based on subjective, radiographic and functional criteria during the 12-month follow-up study.


femoral neck fracture, elliptical hemiprosthetic head, a biarticular spherical hemiprosthetic head, monoarticular spherical hemiprosthetic head

Full Text


Andersson G, Muller Neilsen J. Results after arthroplasty of the hip with Moor’s prosthesis. Acta Orthop Scand. 1972;43(5):397-410. doi:10.3109/17453677208998960.

Cathcart RF. The shape of the femoral head and preliminary results of clinical use of non-spherical hip prosthesis. J Bone Joint Surg. 1972;53A:397.

Kennedy WR. Treating femoral neck fracture with the Cathcart prosthesis: a preliminary report. Contemp Orthop. 1982;4:1-6.

Pipino E, Molfetta L. The ‘Cathcart orthocentric’ elliptical head endoprosthesis. A long-term clinical and radiographic study. Ital J Orthop Traumatol. 1989;15(1):5-14.

Simone C, Patella V, Moretti B, Molfetta L. Short-term clinical results with an elliptical femoral prosthesis. Hip Int. 1995;5(1):15-9.

Bullough PG, Goodfellow JW, O’Conner JJ. The relationship between degeneration changes and load-bearing in the human hip. J. Bone Joint Surg. 1973;55(4):746-58.

Patel KC, Moradiya N, Gewatre P, Dasai TV. Early outcome of hemireplacement arthroplasty using cemented bipolar prosthesis in fracture neck femur in elderly: A study of 50 cases. Int J Orthop Sci. 2017;3(1):303-7. doi: 10.22271/ortho.2017.v3.i1e.48

Kenzora JE, Magaziner J, Hudson J, Hebel JR, Young Y, Hawkes W, et al. Outcome after hemiarthroplasty for femoral neck fractures in the elderly. Clin Orthop Relat Res. 1998; (348):51-8.

Angelini S, Biancalani D, Martelli F, Davini PG, De Luca L. The Cephalic Prosthesis “ELLITICA” for Femoral Neck Fractures. Regione Toscana – Local Health Autirity USL 11 U.O.S. of Traumatology Ospedale San Giuseppe

Coleman SH, Bansal M, Cornell CN, Sculco TP. Failure of bipolar hemiarthroplasty: a retrospective review of 31 consecutive bipolar prostheses converted to total hip arthroplasty. Am J Orthop (Belle Mead NJ). 2001;30(4):313-9.



Article Tools
Email this article (Login required)
About The Authors

Nikolay Kolarov
Medical University of Varna

Orthopedic and Traumatology Clinic, St. Anna University Hospital, Varna

Ruslan Popstefanov
Medical University of Varna

Orthopedic and Traumatology Clinic, St. Anna University Hospital, Varna

Font Size