Bipolar Hip Arthroplasty Research Articles

III–2 LIPUS Treatment for Periprosthetic Fractures Following Bipolar Hip Arthroplasty

III–2 LIPUS Treatment for Periprosthetic Fractures Following Bipolar Hip Arthroplasty

A seven- to 14-year follow-up study of bipolar hip arthroplasty in the treatment of osteonecrosis of the femoral head

Bipolar hip arthroplasty (BHA) in the treatment of Ficat stage III osteonecrosis of the femoral head (ONFH) has theoretical advantages over total hip replacement (THR) in that it preserves the natural acetabulum and uses an implant that allows better stability and larger range of movement. The purpose of this study was to evaluate the clinical and radiological outcomes of BHA with uncemented ingrowth stems in the treatment of ONFH. Thirty-nine hips in 34 patients (two women and 32 men) with a mean age at the time of surgery of 45.31 years (range 30-66 years) operated between 1998 and 2005 were examined in a retrospective evaluation. Mean follow-up was 9.5 years (range 3-14 years). Patients were evaluated with the Harris hip score (HHS). Kaplan-Meier survivorship was calculated to examine the revision rate. Radiographic analysis included evaluation of bipolar head migration, radiolucent lines around the stem and osteolysis in the acetabulum and the femur. Evaluation of clinical results revealed an increase in HHS from 28 points preoperatively to 88.6 points at the most recent follow-up. Radiographic evaluation showed bipolar head migration in 3 hips (7.7%). Survival rate of BHA, with revision THR defined as the endpoint, was 92.31% at ten years (CI 95%). All implanted uncemented stems were stable without any radiographic signs of loosening or osteolysis. The results of the present study show that implantation of BHA with uncemented ingrowth stem in Ficat stage III is still justified.

Bilateral Typical Femoral Fractures in a Patient with Metastatic Breast Cancer on Long-Term Bisphosphonate Therapy: A Case Report

An atypical femoral fracture may be one of the devastating side effects of bisphosphonate. We present a patient who obliged to multiple surgeries for atypical femoral fracture of the femur after bisphosphonate therapy. A 63-yearold woman had been on anti-estrogen therapy for skeletal metastasis of the breast cancer. She received 90 mg of pamidronate disodium for 2 years and 4 mg of zoledronic acid for 4 years. Four month after she developed spontaneous left thigh pain, she fell from a standing height. X-ray films showed a subtrochanteric fracture of the left femur. The patient underwent surgery with an intramedullary nail, and radiation therapy was delivered to the fracture site because the possibility of a pathological fracture was unable to be excluded. Radiographs showed some evidence of callus formation, but the fracture line persisted. Two years later, the intramedullary nail broke at a screw hole in radiographs. Bipolar hip arthroplasty was performed and bone chips were grafted at the fracture site. Ten weeks after the operation, callus formation was satisfactory and she was able to walk without pain. One year after the first operation on the left femur, she complained of spontaneous pain in the right thigh and radiographs showed a lateral cortical beak sign with no evident fracture line. The patient underwent intramedullary nailing to prevent subsequent fracture. The radiological fracture sign were improved one year after the operation. The prophylactic intramedullary nailing is effective for the patients with lateral cortical thickening and/or a medial spike on X-ray.

Two cases that caused central migration for early infection after bipolar hip arthroplasty

Two cases that caused central migration for early infection after bipolar hip arthroplasty

Evaluation of Lifestyle Guidance to Total Hip Arthroplasty and Bipolar Hip Arthroplasty Patients by Cooperation of Nurses and Physical Therapists

Evaluation of Lifestyle Guidance to Total Hip Arthroplasty and Bipolar Hip Arthroplasty Patients by Cooperation of Nurses and Physical Therapists

Relationship between beginning day of loaded gait and ability to walk after bipolar hip arthroplasty of femoral neck fracture

Relationship between beginning day of loaded gait and ability to walk after bipolar hip arthroplasty of femoral neck fracture

The outcome of femoral neck fracture with cementless bipolar hip arthroplasty

The outcome of femoral neck fracture with cementless bipolar hip arthroplasty

Result of a Minimum Five-Year Follow-Up of Hip Arthroplasty Using the Bencox® Hip Stem

Purpose: The purpose of this study is to report the results of artificial hip arthroplasty with minimum five-year follow-up using the Bencox (Corentec) hip stem, the first total hip prosthesis developed in Korea. Materials and Methods: We evaluated 27 hips in patients with femoral neck or intertrochanteric fracture (fracture group) and 58 hips in patients with arthritis or osteonecrosis of the femoral head (arthritis group) who underwent hip arthroplasty using a Bencox hip stem in combination with Bencox bipolar cup and Bencox acetabular cup between September 2006 and February 2008. Patients in the fracture group underwent bipolar hip arthroplasty, and those in the arthritis group underwent total hip arthroplasty. Results: During the follow-up period, there were no cases of revision of the femoral stem. Mean Harris hip score was 94 at the latest follow-up in (femoral neck or intertrochanteric) the fracture group, and improved from 57 preoperatively to 98 at the latest follow-up in the arthritis (or avascular necrosis) group. Radiographically, endosteal bone ongrowth was found in 23 of 27 cases in the fracture group (85.2%) and 56 of 58 cases in the arthritis group (96.6%). Stem loosening, infection, dislocation, and ceramic breakage were not noted. Conclusion: Clinical and radiographic evaluations of hip arthroplasty using the Bencox hip stem showed excellent outcomes with a minimum of five-year follow-up.

A study of femoral antetorsion for bipolar hip arthroplasty

A study of femoral antetorsion for bipolar hip arthroplasty

Ultrasound-guided Fascia Iliaca Compartment Block for Bipolar Hip Arthroplasty in a Moribund Patient

Ultrasound-guided Fascia Iliaca Compartment Block for Bipolar Hip Arthroplasty in a Moribund Patient

Perioperative management of factor XI deficiency in a patient undergoing hip arthroplasty

Factor XI deficiency, or hemophilia C, is a rare autosomal recessive bleeding disorder often diagnosed by inappropriate bleeding associated with trauma or a surgical procedure, and reports of anesthetic management of this disorder are rare. We experienced an 85-year-old man with femoral neck fracture who was diagnosed preoperatively with factor XI deficiency based on abnormally long activated partial thromboplastin time (APTT). He was scheduled for bipolar hip arthroplasty and was prepared for surgery by transfusion of fresh frozen plasma (FFP), instead of factor XI concentrates, which are not commercially available in Japan. Five units of FFP were transfused 6 days before surgery, and 10 units of FFP with 2 units of red concentrated cells (RCC) were used on the day of surgery. Transfusion of FFP shortened the APTT to a level sufficient to allow hemostasis, although not to within the normal range. Although the patient required transfusion of 2 units of RCC postoperatively, no bleeding complications occurred. For bipolar hip arthroplasty, transfusion of FFP produced sufficient hemostasis without the use of tranexamic acid, factor VII preparations, or desmopressin.

Le fratture mediali: quando e quale protesi

Femoral neck fractures in the elderly are frequent, represent a serious health care problem, and have a significant impact on health costs. Reconstruction options using hip arthroplasty include bipolar hemiarthroplasty (HA) and total hip arthroplasty (THA). The purpose of this review is to discuss the indications, limitations, and pitfalls of each of these techniques.

Study on Walking Ability after Surgery for Proximal Femoral Fracture in Elderly Patients Aged 75 Years or Older

Background: Fractures of the hip are the cause of hospitalization in the geriatric population. In many cases, hip fractures are a sentinel event signaling a systemic decline in the patient’s health. Methods: A retrospective review of the cases of 88 patients aged 75 years or older with proximal femoral fracture was performed. Fracture types, surgical procedures, walking ability before the injury and at discharge, and waiting time from injury to surgery were obtained. Results: No significant difference was observed in walking ability before injury among patients with femoral neck fracture treated with bipolar hip arthroplasty (BHA) or open reduction and internal fixation (ORIF) and those with trochanteric fracture. The degree of deterioration of walking ability was 0.6 in patients treated with BHA, 1.2 in those with neck fracture treated with ORIF, and 1.1 in those with trochanteric fracture. Deterioration was significantly less severe in patients who received BHA, compared with those who received ORIF. Conclusions: Among the patients aged 75 years or older with femoral neck fracture, those who received BHA had a shorter time interval to the start of walking with parallel assist bars or with walking aids, and also had a higher rate of regaining walking ability.

A case report of paradoxical brain embolism after bipolar hip arthroplasty

A case report of paradoxical brain embolism after bipolar hip arthroplasty

Results of Anterior and Posterior Capsuler Approaches in Bipolar Hemiarthroplasty Patients with Femoral Neck Fractures

We evaluated the functional status and postoperative complications of bipolar hemiarthroplasty patients with femoral neck fractures, which we operated using anterior and posterior approaches. Between November 2007 and February 2011, 224 patients were evaluated according to their surgical exposure type in two groups. The first group, which was approached anteriorly to the joint capsule, included 92 patients, and the second group, approached posteriorly, included 132 patients. The mean follow-up period for group 1 was 16.4 months and for group 2 was 18.9 months. Harris hip score of group 1 was 81.7 and of group 2 was 79.2. In group 1, 19 patients had very good, 52 patients good, 15 patients moderate, and 6 patients insufficient results. In group 2, 29 patients had very good, 74 patients good, 21 patients moderate, and 8 patients insufficient results. Although we had higher hip dislocation and infection rates in group 2, there were no statistical differences between the two groups. Surgical exposure type does not affect functional outcome in bipolar hip arthroplasty patients. Although statistically insignificant, we had higher hip dislocation and infection rates using the posterior approach in the selected femoral neck fracture patients. An anterior approach to the joint capsule appears to be more reliable.

Evaluation of Accuracy of Bipolar Hip Arthroplasty Using a Digital Template

Evaluation of Accuracy of Bipolar Hip Arthroplasty Using a Digital Template

A Useful Device for Trial Reduction in Bipolar Hip Arthroplasty through a Direct Anterior Approach

A Useful Device for Trial Reduction in Bipolar Hip Arthroplasty through a Direct Anterior Approach

Outcome of bipolar hip arthroplasty by JMM PerFixHA stem for elderly femoral neck fracture

Outcome of bipolar hip arthroplasty by JMM PerFixHA stem for elderly femoral neck fracture

A five‐year clinical and radiographic follow‐up of bipolar hip arthroplasty with insertion of a porous‐coated anatomic femoral component without cement

To evaluate the clinical and radiographic outcomes of bipolar hip arthroplasty with a cementless porous-coated anatomic femoral component. Fifty-nine patients (86 hips) with a minimum 3.5-year follow-up were followed up for a mean of 5.2 years (from January 2005 to January 2007). Standard clinical evaluation utilizing the Harris hip score and radiographic evaluation based on the criteria of the Hip Society were used in this prospective study. Radiographic assessment included evaluation of calcar remodeling and pedestal formation. The average age of the patients (24 men and 35 women) at the time of surgery was 71.4 years (range, 69-84 years). The average preoperative Harris hip score was 48.5 ± 4.0 (range, 25-65) points, pain score 15.2 ± 3.9 (range, 0-20) points and functional score 26.7 ± 4.6 (range, 9-40) points. At the time of the latest follow-up, the average Harris hip score was 96.1 ± 2.1 (range, 67-100) points, pain score 42.6 ± 6.3 (range, 32-54) points and functional score 45.5 ± 4.7 (range, 29-56) points. Five hips (5.81%) had pain in the anterior part of the thigh. Two hips (2.33%) required revision of the femoral component because of aseptic loosening and periprosthetic fracture. Radiographic assessment revealed consistent evidence of proximal bone ingrowth. No completely radiolucent lines were identified, except around stems that had loosened. Twenty-seven femoral components (31.4%) had associated slight pedestal formation. No osteolytic lesions of the femur were identified. Nonprogressive pelvic osteolysis was identified in four hips, none of the lesions being ≥2mm in diameter. An anatomically designed prosthesis can provide good clinical results, with low incidence of thigh pain and loosening of the component.

Total hip arthroplasty and bipolar hip arthroplasty in patients with liver cirrhosis

Total hip arthroplasty and bipolar hip arthroplasty in patients with liver cirrhosis