Efficacy of Calcar Reconstruction using Autologous Bone Graft in Bipolar Hemiarthroplasty for Geriatric Patients: A Case Series of 20 Patients in a Low-income Setting

Femoral neck fractures in the elderly are a significant health concern, particularly in low-income settings where total hip arthroplasty may not be feasible. Bipolar hemiarthroplasty is a preferred treatment, but the absence of a supportive calcar can compromise implant stability, leading to complications such as subsidence and periprosthetic fractures. This study evaluates the efficacy of calcar reconstruction using an autologous bone graft in geriatric patients undergoing bipolar hemiarthroplasty. A prospective case series was conducted on 20 patients (aged > 65 years) with displaced femoral neck fractures. During bipolar hemiarthroplasty, the calcar was reconstructed using an autologous femoral head graft. Functional and radiological outcomes were assessed at 6 and 12 months postoperatively using the Harris Hip Score (HHS) and implant stability parameters. At 6 months, the mean HHS was 85.2 ± 7.1, improving to 89.4 ± 6.3 at 12 months. Only one case (5%) of implant subsidence (>3 mm) was noted. There were no dislocations, and 80% of patients regained independent ambulation within 6 months. Calcar reconstruction with an autologous bone graft improves implant stability, enhances functional recovery, and reduces complications, making it a cost-effective alternative in resource-limited settings..