There is good evidence that cementing the prostheses in place will reduce post-operative pain and lead to better mobility. From the trials to date there is no evidence of any difference in outcome between bipolar and unipolar prosthesis. There is some evidence that a total hip replacement leads to better functional outcome than a hemiarthroplasty. Further well-conducted randomised trials are required.
Use of a hydroxyapatite-coated hemiarthroplasty in the management of subcapital fractures of the femur.
A prospective clinical trial has been conducted comparing the use of a hydoxyapatite-coated bipolar hemiarthroplasty and an uncemented bipolar prosthesis in the treatment of displaced subcapital fractures of the femur. The trial was conducted over 1 year, 82 patients suffering displaced subcapital fractures of the femur were included. The patients were followed up for 1 year postoperatively. The functional result was significantly superior in the hydroxyapatite-coated group. Characteristic changes were found on radiographs both proximally and distally, indicating that distal stem fixation with proximal stress shielding had occurred.