Ong bc, maurer sg, aharonoff gb, zuckerman jd, koval kj. The neck is a part of femur bone which connects head of the femur bone to its shaft. This prospective randomized trial compared the efficacy of unipolar versus bipolar hemiarthroplasty in elderly patients or 65 years with displaced femoral neck fractures in terms of quality. Among patients who were able to walk unaided before injury, more of those having bipolar hemiarthroplasty were able to do so at month 4 than those having unipolar hemiarthroplasty % vs. Bipolar hemiarthroplasty in unstable trochanteric fractures. Emre yurdakul,1 fatih karaaslan,2 murat korkmaz,2 fuat duygulu,3 ali baktir41department of orthopedics and traumatology, osmaniye state hospital, 2department of orthopedics and traumatology, faculty of medicine, bozok university, yozgat, 3department of orthopedics and traumatology, kayseri.
Twenty percent of the patients in the unipolar ha group displayed acetabular erosion at the 12month followup compared to 5% in the. Comparative study of bipolar hemiarthroplasty for femur neck. The revision types were divided into subtypes that. Hemi means half, and arthroplasty means joint replacement. This easy assembly does not affect separation strength because the selfcentering bipolar exhibits superior pullout strength 2180 newtons. Five of the studies,14,16,17,19, on a total of 452 patients, showed major methodrelated complications. Although the results of the previous studies are promising, there is still no definitive answer and the treatment norm has not changed.
Unipolar versus bipolar hip hemiarthroplasty in the treatment. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures. Bipolar versus unipolar hemiarthroplasty for patients with. Fiftythree cemented and 53 cementless prostheses were implanted on alternate days in 106 consecutive patients. Unipolar vs bipolar hemiarthroplastydennis zw ng and kevin bl lee 198 materials and methods all patients who underwent hemiarthroplasty for displaced neck of femur fractures between 1 january 2004 and 31 december 2007 were analysed from a log of all operative procedures. The uncemented bipolar hemiarthroplasty for displaced femoral neck. Unstable intertrochanteric fractures managed by cemented bipolar hemiarthroplasty.
Bipolar hemiarthroplasty for femoral neck fracture using. The operation is similar to a total hip replacement but it involves only half of the hip. Bipolar hemiarthroplasty, total hip replacement, neglected femoral neck fracture, hip fracture introduction hip fracture is an international public health problem mainly occurring in elderly patients and resulting in a high mortality. Pdf zusammenfugen pdfdateien online kostenlos zu kombinieren. But the plastic cup is permanently attached to the metal stem with a universal joint effect so it can move around just like an artificial hip, like this. Bipolar versus unipolar hemiarthroplasty for patients with a hip fracture the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. A related but distinct complication of bipolar arthroplasties is the development of component dissociation. Bipolar versus unipolar hemiarthroplasty for patients with a. Although the results of the previous studies are promising, there is still no definitive answer and the. The age, sex, body mass index bmi, time from admission to surgery. Electrosurgery makes use of highfrequency electrical current to cut, coagulate, desiccate, and fulgurate tissue and can be performed using either monopolar or bipolarenergy in conjunction with a specialized instrument. A prospective, randomised study was conducted to evaluate the clinical and functional outcomes at 12 months of followup in two groups of patients affected by femoral neck fractures and treated with cemented or cementless bipolar hemiarthroplasty.
Displaced femoral neck fractures fnfs in healthy elderly patients have traditionally been managed with hemiarthroplasty ha or total hip arthroplasty tha, with studies suggesting that tha may be the better option. Pdf comparison of bipolar hemiarthroplasty and total hip. Angerman, comminuted intertrochanteric fractures treated with a leinbach prosthesis, clinical orthopaedics and related research, vol. Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. To evaluate whether walking ability recovers early after bipolar hemiarthroplasty bha using a direct anterior approach methods. Dislocation after bipolar hemiarthroplasty in patients with. Pdf unipolar versus bipolar uncemented hemiarthroplasty. Hemiarthroplasty 4 contributes to early ambulation and good functional recovery.
Bipolar or unipolar hemiarthroplasty after femoral neck. Inngul c, hedbeck cj, blomfeldt r, lapidus g, ponzer s, enocson a. Hip hemiarthroplasty is an orthopedic procedure for the treatment of certain femoral neck fractures where the femoral head is removed and replaced. Background displaced fracture of the femoral neck has been a common clinical problem, especially in aged patients. Among the 40 patients that attended the last followup, the mean acetabulum score of the bipolar group patients was somewhat higher. In this study, a bipolar component was used in 90% of the patients undergoing hemiarthroplasty and a monopolar component for the other 10% of the patients. Between 2008 and 2010, 81 patients with femoral neck fracture underwent bha using the direct anterior approach daa or the posterior approach pa. Whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty uh remains controversial. You may not embed one of our images on your web page without a link back to our site. Dislocation after bipolar hemiarthroplasty in patients.
Is cemented bipolar hemiarthroplasty a safe treatment for. There was no significant heterogeneity unipolar versus bipolar hemiarthroplasty for elderly patients with femoral neck fractures. Due to lack of classification system in these previous studies, we cannot determine which complication is expected to occur in which type of revision. Among them, numbers of orthopaedic surgeons regard bipolar hemiarthroplasty as a treatment of choice for the patients with displaced femoral neck fracture due to the. This article discusses the use of both unipolar and bipolar prostheses for treatment of femoral neck fractures in. During the hemiarthroplasty procedure, the damaged femoral head and. Hemiarthroplasty of the hip is one of the surgical treatments for femoral neck fractures, replacing the head due to the high risk of posttraumatiic avascular necrosis. Advantages of the unipolar prosthesis include lower cost and no risk of polyethylene wear debris.
This surgical procedure replaces the head of a damaged femur with an implant designed to stabilize the femur and restore hip function. Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures. Hemiarthroplasty is indicated for the surgical treatment of subcapital neck fractures that are displaced and at high risk of femoral head avascular. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in. Unipolar versus bipolar hip hemiarthroplasty in the. These prostheses can be inserted with or without bone cement. A total hip replacement total hip arthroplasty or tha. Bipolar hemiarthroplasty joint replacement patient forum.
Pdfdateien in einzelne seiten aufteilen, seiten loschen oder drehen, pdfdateien einfach zusammenfugen oder. A hemiarthroplasty is an operation that is used most commonly to treat a fractured hip. Even though, the revision rate of ha group appeared to be more than two folds higher than that after thr, 78% resulted from erosion in ha group. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly. Mbbs singapore, mrcs edinburgh mrcs edinburgh, mmed. Unipolar depression is a mental disorder that results in a patient having episodes of lowmood, low selfesteem, loss of interest, loss of pleasure in enjoyable activities. Hemiarthroplasty means replacing the hip joint with a metal prosthesis. If you would like a large, unwatermarked image for your web page or. Interventionone hundred one patients received a cemented bipolar prosthesis and 180 received a. Unipolar, bipolar or total hip endoprosthesis after. A systematic literature search up to april, 2014 was conducted to include rcts comparing bh with uh for. Jul 14, 2016 bipolar or hemiarthroplasty is a surgical procedure which replaces one half of the joint with an artificial surface and leaves the other part in its natural preoperative state.
There are two types of options, including unipolar hemiarthroplasty uh and bipolar hemiarthroplasty bh, when using a hemiarthroplasty. Unipolar or bipolar hemiarthroplasty for femoral neck. The large prosthetic head can be removed and a smaller one attached to the femoral stem and an. Hemiarthroplasty unipolar and bipolar indications approach and procedure moderator. The authors performed a systematic database search, till april 2014, to identify all rcts which compare uh to bh, as treatment of displaced femoral neck fractures. The prosthetic femoral head that articulates in the acetabulum same as unipolar, and a second area of articulation. Hip hemiarthroplasty bipolar orthopedic associates of. A systematic literature search up to april, 2014 was conducted to include rcts comparing bh with uh. Bipolar or hemiarthroplasty is a surgical procedure which replaces one half of the joint with an artificial surface and leaves the other part in its natural preoperative state. To compare outcomes of unipolar versus bipolar uncemented hemiarthroplasty and determine factors affecting outcomes. A person may start of being happy and then go quickly to becoming sad or depressed.
In a total hip replacement the socket is also replaced. In a unipolar hemiarthroplasty only the prosthetic femoral head articulates in the acetabulum, only one point of movement uni 1 in a bipolar hemiarthroplasty there are two points of movement bi 2. Unlike total hip replacement, in which both the ball of the femur and the hip socket are replaced, in this procedure, only the ball is replaced. Effect of component design in retrieved bipolar hip. Bipolar unipolar lower cost simpler bipolar less wear more modular more expensive can dissociate can convert to total hip arthroplasty 49. Aug 28, 2015 displaced femoral neck fractures fnfs in healthy elderly patients have traditionally been managed with hemiarthroplasty ha or total hip arthroplasty tha, with studies suggesting that tha may be the better option. To assess the safety and efficacy that compare bipolar hemiarthroplasty with unipolar hemiarthroplasty for the treatment of femoral neck fracture in the patient aged more than 65 years. Factors that could play a role in decisionmaking include patient age, activity level, and associated medical conditions. Bipolar means that the prosthesis is in two parts, a bit like a total hip.
Dec 20, 2019 bipolar hip prosthesis, fenestrated stem, sterile, ss. The aim of this study was to compare the outcome of unipolar with the bipolar prosthesis in geriatric patients. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures. Radiological failures were observed in hips in one case 2. Bipolar hemiarthroplasty in elderly patients presenting. However, it has recently been reported that bipolar ha bha also provides good outcomes, and it is not clear as to whether bha or tha is most appropriate.
Unipolar versus bipolar hemiarthroplasty for displaced. The prosthetic head articulates with the native acetabulum hence it is designated as hemi. Hemiarthroplasty of the hip physical therapy in seattle. Bipolar hemiarthroplasty, neck pain, neck fracture, bone. Among these procedures, hemiarthroplasty has become the most preferred treatment option for surgeons according to the surveys. This prosthesis is a bipolar hemiarthroplasty which can be converted to a total hip arthroplasty in the future. The bipolar hemiarthroplasty group showed better results than the compression hip screw group for anesthesia time and the time of partial weightbearing using a walker. Full text is cemented bipolar hemiarthroplasty a safe. However, the optimal treatment choice remains controversial. Bipolar electrosurgery electrosurgery makes use of highfrequency electrical current to cut, coagulate, desiccate, and fulgurate tissue and can be performed using either monopolar or bipolar energy in conjunction with a specialized instrument. Proposed advantages of the bipolar prosthesis include less acetabular wear and potentially less hipgroin pain.
The purpose of this study was to compare observed damage modes. The hhs scores were equal at both followups, but there was a trend towards better hrqol in the bipolar ha group at four months, eq5d index score 0. Comparison of bipolar hemiarthroplasty with cemented vs. Hemiarthroplasty using modular head partial prostheses is a common surgical procedure used to treat elderly patients with femoral neck fractures. Each of these two modalities has specific advantages and understanding the difference between the two can help you understand the differences in how theyre used. Insertion of a hemiarthroplasty is a well established treatment for a dislocated medial hip fracture in elderly patients. A bipolar prosthesis has an additional artificial joint between the two components of the prosthesis. Outcome of hemiarthroplasty and total hip replacement for. However, controversy persists as to whether cemented. Fortyone patients above 60 years of age and an acute displaced fracture of the femoral. The comparison of compression hip screw and bipolar. The decision to perform hemiarthroplasty using a unipolar or bipolar prosthesis remains controversial, with proponents on either side.
However, there is inadequate evidence to support the choice between unipolar or bipolar hemiarthroplasty. Is cemented bipolar hemiarthroplasty a safe treatment for femoral neck fracture in elderly patients. The purpose of this study is to compare unipolar and bipolar hemiarthroplasty as a treatment for patients aged 70 years or above with a dislocated medial femoral neck fracture. The operation is similar to a total hip replacement, but it involves only half of the hip. Sep 04, 2008 hemiarthroplasty means replacing the hip joint with a metal prosthesis. Bipolar hemiarthroplasty in elderly patients presenting with. Abduction brace was applied for 6 weeks to prevent redislocation, and none has occurred afterward. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty. Unipolar or bipolar hemiarthroplasty in the treatment of.
Other investigators, however, have reported that conversion of hemiarthroplasty to thr is associated with high complication and loosening rates compared to primary total hip arthroplasty. The hemiarthroplasty replaces only the ball portion of the hip joint, not the socket portion. The hip revision classification system is based upon site and mode of failure. Unipolar versus bipolar hemiarthroplasty malaysian orthopaedic. Hemiarthroplasty is a common procedure in the treatment of femoral neck fractures in the elderly. Dislocation of the hemiarthroplasty from the native acetabulum is a welldocumented, albeit rare, complication and is reported to occur in 1. Nov 11, 2015 unipolar versus bipolar hemiarthroplasty.
Difference between bipolar and unipolar bipolar vs unipolar. Proposed advantages of the bipolar prosthesis include. Mor test tips intertrochanteric hip fractures feat. A metaanalysis chen jiangtao1, zhou yijun2, xun chuanhui1, huo jianjun3, song xinghua1, tian zheng1, akbar yunus1, cao li1 1orthopaedic department, the first affiliated hospital of xinjiang medical university, urumqi 2orthopaedic department, the first peoples hospital of changde 3orthopaedic. Comparison of bipolar hemiarthroplasty and total hip.
Dissociation of a bipolar prosthesis after right hip. The hip coxofemoral joint is a large and stable diarthroidal ballandsocket joint formed by the articulation between the femoral head and the. Abuelela, primary bipolar hemiarthroplasty in unstable intertrochanteric fractures in elderly, 24th sicot meeting international. Due to the unsatisfactorily high level of uncertainty, this study was undertaken to analyze the relationship between perioperative parameters, functional outcome and complications of bipolar hemiarthroplasty in elderly patients with displaced intracapsular femoral neck fractures and to. Primary articulation of bipolar hemiarthroplasty systems is at the femoral headliner interface. Comparative study of bipolar hemiarthroplasty for femur. Pdf unipolar versus bipolar hemiarthroplasty for displaced. Unipolar prostheses has a onepiece design where the hip movement occurs between the prosthesis and the acetabulum hip socket. Unstable intertrochanteric fractures managed by cemented.
Hemiarthroplasty of the hip is one of the surgical treatments for femoral neck fractures, replacing the head due to the high risk of posttraumatiic avascular necrosis this prosthesis is a bipolar hemiarthroplasty which can be converted to a total hip arthroplasty in the future. Revisions are classified by type, indicating whether the problem in the acetabulum or femur or both. The large prosthetic head can be removed and a smaller one. There were no significant differences between the groups regarding complications. Bipolar disorder is a condition in which people experience extensive mood swings. Hip replacement surgery can be performed as a total replacement or a hemi half replacement. Bipolar hip prosthesis, fenestrated stem, sterile, ss. Hip fractures in elderly patients treated with bipolar. Patients and participantstwo hundred eightyone community dwelling elderly patients sixtyfive years of age or older who sustained a displaced femoral neck fracture garden types iiiiv and underwent primary prosthetic replacement. Our results suggest that there is no significant difference in incidence of dislocation between patients with or without neuromuscular disease by maintaining adequate soft tissue tension using. Only prospective randomized controlled trials rcts. Bipolar hemiarthroplasty hemiarthroplasty is done for fracture neck of femur. In the treatment of older patients with displaced femur neck fracture, bipolar hemiarthroplasty bha is a more commonly accepted treatment, compared with internal fixation, because this modality offers advantages.
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