Functional outcome of hip hemiarthroplasty done through modified Hardinge approach in femoral neck fractures: a prospective study of 50 cases

Abstract

Background: Femoral neck fractures are common injuries in older adults and are associated with substantial morbidity and mortality. Arthroplasty is widely used for displaced intracapsular femoral neck fractures in older patients, while the choice of surgical approach and implant fixation remains an important part of perioperative decision-making. Methods: This prospective study included 50 patients with femoral neck fractures treated between March 2023 and February 2025. Patients were followed for 6 months to 1 year. Functional outcomes were assessed using the Harris hip score (HHS). Results: The mean age was 72±8.16 years. Women comprised 60% of the cohort and men 40%. Left-sided fractures accounted for 52% and right-sided fractures for 48%. Most injuries followed low-energy trauma. Uncemented implants were used in 47 patients (94%) and cemented implants in 3 (6%). The mean interval from injury to surgery was 5.5 days. At final follow-up, 72% of patients had good, 18% excellent, 8% fair, and 2% poor functional outcomes. Overall, complications occurred in 20% of patients. Conclusions: Hip hemiarthroplasty through the modified Hardinge approach was associated with favorable functional outcomes in this prospective cohort, with most patients achieving good-to-excellent HHS and a relatively low frequency of major complications.