IJCRR - Vol 07 Issue 07, April, 2015
FUNCTIONAL AND RADIOLOGICAL OUTCOME OF UNCEMENTED BIPOLAR ARTHROPLASTY
IN UNSTABLE INTERTROCHANTERIC FRACTURES OF THE ELDERLY
Author: Jalaluddeen Mahin Vaidyar, Sandeep Shibli, U. Hashir Safwan, Shabir Kassim
Background: Bipolar hemiarthroplasty is an effective option for unstable intertrochanteric fractures in the elderly. This study evaluated the functional and radiological outcome following uncemented hemiarthroplasty in elderly unstable intertrochanteric fractures
Methods: 25 hips were followed for a period of 1 year after hemiarthroplasty with a blast coated revision stem (Orthovasive). The mean age was 77 and mean follow up 16 months. The modified Merle D’Aubigne score was assessed for function and radiological results were assesses using a range of indices.
Results: At the last follow up the mean Merle D’Aubigne score was 14.5. Twenty cases (80%) regained their preoperative walking ability postoperatively. Radiologically, there were 15 cases (60%) of bone in growth and 10 cases (40%) with stable fibrous fixation. Endosteal new bone formation was found in 10 (40%) patients. There were no cases with progressive subsidence or significant changes in alignment.
Conclusions: The functional and radiological outcome after 1 year followup in unstable intertrochanteric fractures in elderly patients with uncemented bipolar arthroplasty was satisfactory.
Keywords: Elderly, Unstable intertrochanteric fracture, Uncemented bipolar arthoplasty
Jalaluddeen Mahin Vaidyar, Sandeep Shibli, U. Hashir Safwan, Shabir Kassim. FUNCTIONAL AND RADIOLOGICAL OUTCOME OF UNCEMENTED BIPOLAR ARTHROPLASTY
IN UNSTABLE INTERTROCHANTERIC FRACTURES OF THE ELDERLY International Journal of Current Research and Review. Vol 07 Issue 07, April, 35-39
1. Haidukewych GJ, Israel TA, Berry DJ. Reverse obliquity fractures of the intertrochanteric region of the femur. J Bone Joint Surg Am. 2001;83(5):643–650.
2. Kang SY, Lee EW, Kang KS, et al. Mode of fixation failures of dynamic hip screw with TSP in the treatment of unstable proximal femur fracture: biomechanical analysis and a report of 3 cases. J Korean Orthop Assoc. 2006;41(1):176– 180.
3. Hwang DS, Kwak SK, Woo SM. Results of cementless hemiarthroplasty for elderly patients with unstable intertrochanteric fractures. J Korean Hip Soc. 2004;16(3):386–391.
4. Rothman RH, Cohn JC. Cemented versus cementless total hip arthroplasty: a critical review. Clin Orthop Relat Res. 1990;(254):153–169.
5. Christie J, Burnett R, Potts HR, Pell AC. Echocardiography of transatrial embolism during cemented and uncemented hemiarthroplasty of the hip. J Bone Joint Surg Br. 1994;76(3):409–412.
6. Merle d’aubinge R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg [Am] 1954;36-A:451–75.
7. Kang JS, Moon KH, Park SR, Sun SH. Long-term results of total hip arthroplasty with an AML hip prosthesis. J Korean Hip Soc. 2004;16(1):17–23.
8. Kim YH, Kim VE. Cementless porous-coated anatomic medullary locking total hip prostheses. J Arthroplasty. 1994;9(3):243–252. [PubMed]
9. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement: the factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987;69(1):45–55. [PubMed]
10. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res. 1990;(257):107–128. [PubMed]
11. Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979;(141):17–27. [PubMed]
12. Kim YM, Kim HJ, Ahn JH, Kim KH, Kang SB. Early postoperative periprosthetic radiological findings in cementless THRA: comparison between porous-coated implant and hydroxyapatite-coated implant. J Korean Orthop Assoc. 1997;32(4):1005–1014.
13. Stern MB, Angerman A. Comminuted intertrochanteric fractures treated with a Leinbach prosthesis. Clin Orthop Relat Res. 1987;(218):75–80. [PubMed]
14. Moon CY, Ji JH, Park SE, Kim YY, Lee SW, Kim WY. Comparison of the clinical outcomes between internal fixation and primary hemiarthroplasty for treating unstable intertrochanteric fracture in the elderly. J Korean Hip Soc. 2008;20(4):273–277.
15. Green S, Moore T, Proano F. Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly. Clin Orthop Relat Res. 1987;(224):169– 177.
16. Haentjens P, Casteleyn PP, De Boeck H, Handelberg F, Opdecam P. Treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients: primary bipolar arthroplasty compared with internal fixation. J Bone Joint Surg Am. 1989;71(8):1214–1225.
17. Andress HJ, Kahl S, Kranz C, Gierer P, Schurmann M, Lob G. Clinical and finite element analysis of a modular femoral prosthesis consisting of a head and stem component in the treatment of pertrochanteric fractures. J Orthop Trauma. 2000;14(8):546–553. [PubMed]
18. Maloney WJ. Femoral fixation in older patients: uncemented is reasonable in many patients. 74th Annual Meeting of the American Academy of Orthopaedic Surgeons; 2007 Feb 14-18; San diego, CA, USA.
19. Dorr LD, Faugere MC, Mackel AM, Gruen TA, Bognar B, Malluche HH. Structural and cellular assessment of bone quality of proximal femur. Bone. 1993;14(3):231–242.
20. Parvizi J, Holiday AD, Ereth MH, Lewallen DG. The Frank Stinchfield Award: sudden death during primary hip arthroplasty. Clin Orthop Relat Res. 1999;(369):39–48.