Abstract
Introduction: Introduction of bipolar prosthesis was basically made for the treatment of fresh fracture neck of femur in elderly, but with advancement in design and techniques its use has been increased to various non-traumatic hip pathologies.Objective: To assess clinical and radiological outcome of BHU bicentric bipolar hip prosthesis in treatment of non-traumatic hip pathology.Methodology: This longitudinal study was done in 30 cases of various hip conditions, during the period of March 2002 to March 2012. All patients had secondary osteoarthritis of hip with abnormal acetabulum following advanced tubercular arthritis, rheumatoid arthritis, ankylosing spondylitis and avascular necrosis of femoral head. Primary bipolar hemi-replacement arthroplasty was done in all the cases using Banaras Hindu University (BHU) bicentric bipolar hip prosthesis. Each patient was assessed radiologically for movement and fraction of it occurring at various components of prosthesis and clinically for functional outcome using modified Harris hip score for the maximum of 10 years.Results: There were 17 males and 13 females (n=30), aged between 31-60 years. Three and half years following surgery, (n=12) 100% patients were able to squat and sit crossed legged. At four and half years follow-up, (n=7) 100% patient had excellent result when assessed by modified Harris hip score. Radiologically, by the end of 10 years (n=1) all the movements of hip occurred at inner bearing while the outer bearing was fixed to acetabulum.Conclusion: This intermediate term follow-up study suggests that the use of BHU bicentric bipolar hip prosthesis for bipolar hemireplacement is associated with be
Highlights
Bateman and Giliberty introduced bipolar implant for hip reconstruc on, principally in fracture neck of femur, avascular necrosis of femoral head and non-union of femoral neck in an a empt to alleviate the problems of conven onal metallic proximal femoral endoprosthesis.[1,2] The bipolar hip prosthesis has a ball and joint socket, and the majority of mo on is supposed to occur between the small inner metallic head and the ultra-high molecularweight polyethylene (UHMWPE) socket
This intermediate term follow-up study suggests that the use of Banaras Hindu University (BHU) bicentric bipolar hip prosthesis for bipolar hemireplacement is associated with be er clinical outcomes, in non-trauma c hip pathologies
Various other authors have advocated use of bipolar prosthesis in posttrauma c condi ons and avascular necrosis of femoral head. 3-5 With success of bipolar prosthesis in fracture neck of femur, its indica on was extended to various other hip pathologies like advanced osteoarthri s of hip, rheumatoid arthri s, avascular necrosis of femoral head or even cases with acetabular dysplasia, which were previously being treated by total hip arthroplasty
Summary
Bateman and Giliberty introduced bipolar implant for hip reconstruc on, principally in fracture neck of femur, avascular necrosis of femoral head and non-union of femoral neck in an a empt to alleviate the problems of conven onal metallic proximal femoral endoprosthesis.[1,2] The bipolar hip prosthesis has a ball and joint socket, and the majority of mo on is supposed to occur between the small inner metallic head and the ultra-high molecularweight polyethylene (UHMWPE) socket. Several authors have reported good to excellent short-term and intermediate-term results with the use of bipolar prosthesis for osteoarthri s (OA) of the hip, avascular necrosis (AVN) of the femoral head, rheumatoid arthri s (RA), ankylosing arthri s, tuberculosis (TB) of hip.[7,8,9] mid to long-term follow-up demonstrated unacceptably high rates of complica ons like pain, migra on of prosthesis, osteolysis, and the need for revision to total hip arthroplasty.[10,11,12,13] The objec ve of this study was to analyze the long-term outcomes of Banaras Hindu University (BHU) bicentric bipolar hemiarthroplasty applied to these indica ons including the inner and outer bearing movements of the prosthesis
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