Background: Bipolar hemiarthroplasty is a standard treatment for displaced femoral neck fracture in elderly with a normal acetabulum. Several studies have shown controversial results regarding postoperative visual analogue scale, opioid consumption, and the effectiveness of periarticular injection in hip arthroplasty. The purpose of this study is going to identify the effectiveness of periarticular injection after bipolar hemiarthroplasty compared with the patients treated with conventional pain control.
Methods: A prospective, randomized, controlled study was performed for displaced femoral neck fracture in elderly who underwent bipolar hemiarthroplasty from 2017 to 2019. Patients were classified into two groups: Periarticular injection (PAI) group and nonperiarticular injection (non-PAI) group. All patients were recorded pain score (VAS) during admission. Morphine usage was collected in both groups including its side effects.
Results: There was no difference in demography, intraoperative parameters, ambulatory status, and length of stay in both groups. Postoperative VAS at 8,16, 24, 60 hours, and before discharge in the non-PAI group was significantly higher than the PAI group (P = .001, P = .006, P = .002, P = .003, and P = .001, respectively). Morphine consumption at 8 hours after surgery was significantly higher in the non-PAI group than the PAI group (P = .001).
Conclusions: Intraoperative, periarticular injection may be used as an adjunctive pain management in bipolar hemiarthroplasty for displaced femoral neck fracture in elderly.
Level of evidence: level I, Prospective Randomized Controlled Trial.
Keywords: bipolar hemiarthroplasty; effectiveness; elderly; femoral neck fracture; periarticular injection.
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