Predictive Value of Radiographs in Assessment of Post-Hemiarthroplasty Recovery Following Femoral Neck Fractures Amongst the Elderly.

Abstract

Femoral neck fractures are a major cause of morbidity and mortality in the elderly. Hemiarthroplasty is commonly used for displaced femoral neck fractures in this population. However, the association between radiographic parameters and functional recovery post-surgery remains unclear. To evaluate clinical and radiological outcomes after hemiarthroplasty in elderly patients with femoral neck fractures and assess the correlation between functional scores and radiological findings. A cross-sectional observational study was conducted on 71 patients aged ≥60 years who underwent cemented bipolar hemiarthroplasty between November 2016 and October 2020. Functional outcomes were assessed using the Harris hip score (HHS) and Barthel index (BI). A Modified Radiological Score adapted from Dall et al. was employed to evaluate radiographs at a minimum follow-up of 1 year. The mean age was 74.5 years; 56% of patients were female. The mean HHS and BI scores were 79.27 ± 23.3 and 90.31 ± 21.07, respectively, whilst the mean Modified Radiological Score was 1.81 ± 1.33. A significant positive correlation existed between HHS and BI (<i>r</i> = 0.606, <i>p</i> < 0.001), whereas no significant correlation was found between radiological scores and functional outcomes. Cronbach's alpha for HHS improved from 0.681 to 0.775 when the pain component was excluded. Mortality was 17% at 1 year and 39% at 5 years postoperatively. Functional recovery following hemiarthroplasty does not consistently correlate with radiological outcomes. The Harris Hip Score is more reliable when pain is excluded, suggesting functional domains may better reflect true recovery. For instance, a radiologically loose hip can still be clinically pain-free.