Indian Journal of Orthopaedics Surgery · Aug 31, 2026

Primary cemented bipolar hemiarthroplasty for unstable intertrochanteric fractures in the elderly: Early mobilization and functional outcomes

By Barapatre J, Gayan M, Dhurwe A et al.

Introduction: Unstable intertrochanteric fractures in the elderly pose a high risk of fixation failure and immobilization-related morbidity. This study evaluates primary hemiarthroplasty as an alternative to provide immediate stability and facilitate early mobilization.Materials and Methods: A prospective observational study (September 2024–August 2025) enrolled 30 patients (≥ 70 years) with unstable intertrochanteric fractures (Evans Type III: 56.7%, Type IV: 43.3%). All underwent cemented bipolar hemiarthroplasty via a posterior approach, with trochanteric reconstruction as needed. Early post-operative mobilization was protocolized. Functional outcomes (Harris Hip Score [HHS], perioperative parameters, and complications were evaluated over 12 months.Results: The mean patient age was 78.13 ± 4.72 years. All patients ambulated within 3 post-operative days, with 66.7% achieving immediate weight-bearing as tolerated. HHS improved significantly (p < 0.001) from 58.33 at 6 weeks to 85.03 ± 12.42 at 12 months. Complications were minimal (3.3% superficial infection; 3.3% deep vein thrombosis). The 1-year survival rate was 93.3%.Conclusion: In this small cohort of pre-injury community ambulators, primary cemented hemiarthroplasty was associated with acceptable short-term functional recovery and early mobilization in selected elderly patients with unstable intertrochanteric fractures. However, given the absence of a comparative fixation group, small size, and single-center design, these findings should be interpreted as exploratory rather than definitive.

doi.org/10.18231/j.ijos.71862.1788150324 Open access Interventions