Uncemented Bipolar Hemiarthroplasty Research Articles

Comparison of functional outcome in uncemented and cemented bipolar hemiarthroplasty in displaced fracture neck of femur in elderly age group

Some studies recommends uncemented prothesis in treating femoral neck fractures as the blood loss, operative time, and incidence of embolism are lower. On the other hand, others recommend using a cemented prosthesis for fracture neck of femur treatment as there is reduced thigh pain, facilitates early mobilization and a decreased incidence of prosthetic loosening. Uncertainty exists regarding whether a uncemented bipolar hemiarthroplasty for the treatment of displaced femoral neck fractures could have the same clinical outcomes as a cemented bipolar hemiarthroplasty. This study compared a using uncemented and cemented bipolar prosthesis in the treatment of fracture neck of femur

A comparative study of the outcome of displaced fractures neck of femur treated with unipolar prosthesis and fenestrated bipolar prosthesis in active elderly patients

Background: Fractures of the neck or femur are among the most serious surgical problems affecting older groups. These fractures constitute a large burden on families and society due to the inability to stand and walk. Objectives were to compare the functional outcomes of unipolar (Austin-Moore) versus uncemented bipolar hemiarthroplasty in displaced fractures neck femur among these active elderly patients. Methods: This prospective interventional study was carried out at NITOR, Dhaka, Bangladesh in total 60 patients. Among them, 30 patients were treated with unipolar and 30 patients were treated with fenestrated bipolar prosthesis through a lateral approach. Results: There was no significant age difference between the two groups. Regarding the functional outcome, 6 (20%) patients in the unipolar group and 11 (36.67%) patients in the bipolar group had excellent outcomes. About the same number of patients had good outcomes 36.67% in the unipolar and 43.33% in the bipolar group; the fair and poor outcome was more in the unipolar group than the bipolar group. So, the final outcome after 6 months of operation, 57.57% of patients had satisfactory results in the unipolar group whereas 80% of patients had satisfactory results in the bipolar group. The average Harris hip score was 77.14±14.58 in the unipolar group and 84.63±10.15 in the bipolar group and the p=0.01 which is below 0.05. So, the result is statistically significant. Conclusions: Uncemented bipolar hemiarthroplasty with a fenestrated stem can give better functional outcomes for displaced intracapsular femoral neck fractures in active elderly patients compared to Austin-Moore prostheses.

Short-Term Outcomes of Uncemented Bipolar Hemiarthroplasty Using Stainless Steel Fully Hydroxyapatite-Coated Stem in Transcervical Fracture of the Femur.

Bipolar hemiarthroplasty is the standard of care for transcervical fracture in the elderly. Stainless steel being cheaper is preferred over titanium in developing nations for implants and prostheses. This study was conducted for assessing the short-term outcomes of uncemented bipolar hemiarthroplasty done using hydroxyapatite-coated stainless steel prosthesis. Sixty-five patients, >60year of age operated between 2018 and 2020 at tertiary care centre with stainless steel (316L) completely coated with hydroxyapatite bipolar hemiarthroplasty implants were retrospectively followed up. Radiological outcomes were assessed based on pedestal formation, stem position, radiological limb length discrepancy, sinkage of stem, spot welds and stress shielding. Clinical and functional outcomes were assessed based on mean Harris Hip score. Mean Harris Hip score at baseline, 3-week follow-up, 6-week follow-up, 3-month follow-up and 1-year follow-up was 45.9 (SD 2.5), 63.2 (SD 6.5), 75.1 (SD 9.9), 83.9 (SD 9.8) and 87.1 (SD 9.9), respectively. Excellent, good, fair, poor results were seen in 32.31, 40, 18.46, 9.23 of the patients, respectively. Valgus, central and varus stem position was seen in 49.23, 40, 10.77 percent of the patients, respectively. Pedestal formation, radiological limb length discrepancy, sinkage, spot welds, stress shielding was seen in 6.15, 32.31, 3.07, 53.85, 40 percent of the patients, respectively. Short-term outcomes of this study provides evidence that using a more affordable fully hydroxyapatite-coated stainless steel prosthesis for uncemented bipolar hemiarthroplasty is an appropriate treatment option for the transcervical femur fracture.

Outcomes of Uncemented Bipolar Hemiarthroplasty for Femoral Neck Fractures in Elderly Patients with Cardiac Dysfunction

Objectives: Cementless hemiarthroplasty is advised because it reduces the risk of morbidity and mortality in older individuals who use cement. For older patients with high-risk clinical issues who had femoral neck fractures, we assessed the effectiveness of cementless hemiarthroplasty. Materials and Methods: The design of this study was a cross sectional study design and this study was conducted in DHQ Teaching Hospital Gujranwala. 48 patients, including 19 male and 29 female, with an average age of 88-years. using cementless hemiarthroplasty to treat patients with femoral neck fractures. 30 patients (62%) had porous-coated femoral stems, while 18 patients had modular femoral revision stems (38 percent). All patients had bipolar femoral heads. Following surgery, the follow-up radiologically was performed at yearly intervals. Results: The average number of followup years was 4.2. There were no hospital-related deaths among the patients. Six patients (12%) experienced medical difficulties during the period of follow-up, and 4-patients (8%) passed away. Due to acetabular degradation, only the 2 hips were changed to the total hip replacements. One patient was scheduled for a femoral revision due to a sinking of greater than 3 mm. No patients developed heterotopic ossification or acetabular protrusion. The HHA (Harris-hip average) score is 84. One patient experienced dislocation (2 percent). Practical Implication: The advantages of the cemented technique seem to be offset by its mortality risk and the advantages of the cementless option by its increased morbidity. Thus, in some of these very elderly morbid patients the orthopedic surgeon is faced with a dilemma regarding the correct surgical choice, which should be one that can promise pain relief and rapid resumption of function and, at the same time, prevent mortality and reduce morbidity Conclusion: An appropriate form of therapy for fractures in femoral neck in older individuals with risk of clinical issues, particularly those of the cardiopulmonary character, is cementless hemiarthroplasty. With this technique, after cemented hemi-arthroplasty the risk of fat embolism and hypotension is reduced. Keywords: Uncemented Bipolar Hemiarthroplasty, Uncemented Femoral Prosthesis, Hemiarthroplasty In Elderly, Cardiac Dysfunction, Femoral Neck Fracture.

UNIPOLAR VERSUS BIPOLAR HEMIARTHROPLASTY IN ELDERLY PATIENTS WITH FRACTURE NECK OF FEMUR

Background/Purpose: Hemiarthroplasty is the treatment of choice n neck of femur fractures in elderly patients. Unipolar and bipolar prostheses have their own advantages and disadvantages, creating confusion in which prothesis to use. 40 elderly patients (>65 years age) with intracaps Methods: ular neck of femur fractures were included and randomly divided equally in this study, 20 patients were treated with unipolar hemiarthroplasty and 20 patients with bipolar hemiarthroplasty. All patients were evaluated for functional outcome by using Harris Hip score and radiological outcomes using various parameters. The outcomes of both groups were then compared using Chi-square test. Results: Overall mean Harris hip score pre operatively for unipolar hemiarthroplasty was 36.2 and bipolar hemiarthroplasty was 39.1 which increased to 81.8 for unipolar and 85.05 for bipolar hemiarthroplasty respectively, with p-value of <0.561. Our results also shows that we have 35% excellent result in Bipolar whereas we have 15% excellent result in unipolar Hemiarthroplasty group. The results of our study shows that uncemented bipolar hemiarthroplasty Conclusion: gave better results when compared with uncemented unipolar hemiartheoplasty. Our results also shows that, cemented bipolar hemiarthroplasty gave better results when compared with cemented unipolar hemiarthroplasty clinically and radiologically. Thus, Bipolar hemiarthroplasty did better when compared with unipolar hemiarthroplasty in general

Comparison of Clinical Function Outcomes of Patients Performed with Cemented and Uncemented Bipolar Hemiarthroplasty Surgery on Femoral Neck Fractures Using Modified Harris Hip Score and Proportion of Dislocations after Hip Joint Replacement Surgery in Medan

Introduction Fractures of the neck femur that occur in the elderly are caused by minor trauma with most common age more than 50 years old. While in young adult patients, fractures of the neck femur are caused by severe trauma such as a fall from a height or a traffic accident. Hemiarthroplasty cemented or uncemented are the most common methods of treatment neck femur fracture in elderly patients. Modified Harris Hip Score (MHHS) is a tool to measure the functional capacity and pain to assess the conditions of the patients before and after surgical procedures Methodology This is an observational analytic research study with a case control design at Adam Malik Hospital Medan and several network hospitals in Medan. Total of 32 patients with age more than 50 years old were diagnosed with femoral neck fracture with 16 patients underwent cemented bipolar hemiarthroplasty and 16 patients underwent uncemented bipolar hemiarthroplasty surgery during the period September 2021 until August 2022 assessed clinical functional outcome with MHHS scores and the proportion of dislocation 1 month postoperative. Result Mean MHHS value for cemented bipolar hemiarthroplasty was 79.00±5.40 and uncemented bipolar hemiarthroplasty 78.81±7.43 and there were no dislocations 1 month post operation. Discussion Statistical analytic using independent T-Test showing there was no significant different between MHHS scores in cemented bipolar arthroplasty and uncemented bipolar hemiarthroplasty 1 months post operative with P Value 0.935 (>0.05) without any dislocations was found.

Risk Factors for Mortality After Uncemented Bipolar Hemiarthroplasty for Geriatric Displaced Femoral Neck Fracture.

Uncemented bipolar hemiarthroplasty (UBHA) has been widely used to treat geriatric displaced femoral neck fracture (GDFNF), which results in a high 30-day mortality rate among the elderly. To date, few studies have focused on the risk factors for mortality after UBHA for GDFNF. In this retrospective study, elderly patients (age ≥70 years) who underwent UBHA for GDFNF were studied in order to provide helpful insight into the risk factors for mortality postoperatively. This retrospective study enrolled 835 elderly patients who underwent UBHA for GDFNF from January 2010 to December 2017. The Kaplan-Meier method and Cox regression analysis were used to identify significant risk factors predicting mortality after UBHA for GDFNF. Univariate analysis showed that underweight (body mass index <18.5 kg/m2), smoking, alcohol use, hypertension, chronic kidney disease, hypoproteinemia, low activities of daily living (ADL) score (0 to 2), and postoperative delirium were identified as the potential risk factors responsible for mortality after UBHA for GDFNF. Multivariate analysis suggested that underweight, hypoproteinemia, low ADL score, and postoperative delirium were significant risk factors predicting mortality after UBHA for GDFNF. Postoperative delirium was the most robust risk factor for mortality after UBHA for GDFNF. Underweight, hypoproteinemia, and low ADL score were also closely associated with mortality after UBHA for GDFNF. [Orthopedics. 2021;44(4):e570-e576.].

Cemented versus cementless bipolar hemiarthroplasty for femoral neck fractures in the elderly.

The management of femoral neck fractures remains controversial. Treatment options include a wide variety of internal fixation methods, unipolar or bipolar hemiarthroplasty or total hip replacement.We carried out a systematic review of the available literature to detect differences between cemented and cementless fixation of bipolar prostheses in treating femoral neck fractures in patients aged 60 years or older.Thirteen studies involving a total of 1561 bipolar hemiarthroplasties (770 cemented and 791 uncemented) were identified. Uncemented hemiarthroplasty was associated with significantly lower blood loss (p < 0.0001), shorter operative time (p < 0.0001), less infection (p = 0.03) and lower risk of heterotopic ossification (p = 0.007). On the other hand, patients with cemented hemiarthroplasty suffered significantly less postoperative thigh pain than those with cementless implantation (p < 0.00001).The existing evidence indicates that uncemented bipolar hemiarthroplasty offers shorter operative time, less blood loss, lower local complications and a similar rate of systemic complications and reoperations as compared to cemented implantation.Cite this article: EFORT Open Rev 2021;6:380-386. DOI: 10.1302/2058-5241.6.200057

Prospective study of short term functional outcome in elderly patients treated with cemented vs uncemented bipolar hemiarthroplasty for transcervical neck of femur fractures

Objective: Transcervical femur neck fractures are common occurrences in elderly age group leading to significant impact in the health care setup. Bipolar hemiarthroplasty is the commonly performed surgery in this age group. There has been an ongoing debate based on outcome of cemented vs uncemented hemiarthroplasty. The purpose of the study is to evaluate the functional outcome with individual techniques assessed by the Harris Hip Score. Materials and Methods: It was a single centre prospective study with the total sample size of 50. Randomisation was done into 2 groups, one to be treated with uncemented bipolar hemiarthroplasty and the other one with cemented hemiarthroplasty. The comparison was done based on the demographic data, intraoperative parameters, post-operative complications and functions. The patients were followed up till one year and functional outcome was evaluated using the Harris Hip Score. Results: The average age of the patients in the study is 75.02 years, with most patients between 70 -80 years and females (54%) being more than males (46%). Surgical time and blood loss was greater for the cemented (94.4min and 234.8ml) cohort than the uncemented (60.80 min surgical time and 183.20 ml blood loss) (p value < 0.001). However the functional outcome at the end of one year was the similar in both the study groups. Mean Harris Hip Score at 1 year for cemented group was 94.1 and uncemented group was 94.43 with p value = 0.862 (not significant). Conclusion: Based on our results the advantages of using an uncemented hemiarthroplasty are less intraoperative bleeding, shorter duration of surgery which was statistically significant. Both cemented and uncemented hemiarthroplasty are accepted modality of treatment in transcervical femur neck fractures in elderly, as there is no statistical difference in the functional outcome at the end of one year.

Similar recovery in mobility and quality of life after cemented and cementless hemiarthroplasty for hip fractures

Summary: Patients who suffer hip fractures become immobile with reduced quality of life. Our study aims to assess which cemented or cementless hemiarthroplasty resulted in better mobility or quality-of-life scores. Our retrospective review showed that both have similar scores after matching for age, gender, body mass index and comorbidities. Introduction: Hip fractures have mortality rates of up to 10% at 1 month and 30% at 1 year, as well as significant morbidity. This paper seeks to compare mobility and quality-of-life scores of cemented against uncemented hemiarthroplasty for the displaced neck of femur fractures. Our hypothesis is that there is no difference between the mobility and quality of life of patients treated with cemented or uncemented bipolar hemiarthroplasty. Methods: A retrospective review of registry data on hemiarthroplasties performed in our institution between 2011 and 2019 was conducted. From this dataset, 70 cemented hemiarthroplasties and 238 uncemented hemiarthroplasties were identified. Patients were assessed pre- and post-operatively, at 6 weeks, 3 months, 6 months and 12 months to determine functional recovery through mobility and quality-of-life scores. Results: On propensity score matching, both groups showed a reduction in Parker mobility score from 6.5 to 4 ( p = 0.91), SF-36 physical function scores from 52.5 (cemented) to 30 and 57.5 (uncemented) to 25 ( p = 0.79). Comparing the delta changes from pre-fall after matching, no significant differences were observed. From the analysis of the matched set of data, treatment of neck of femur using cemented or non-cemented bipolar hip prosthesis resulted in similar mobility and quality-of-life scores. Conclusion: In our analysis, there was no statistically significant difference in the mobility or quality-of-life scores of the patients undergoing cemented versus uncemented hemiarthroplasty for the displaced neck of femur fractures.

Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: A randomized controlled trial with two years follow-up.

The aim of this prospective randomized trial was to compare cemented (CHA) and uncemented bipolar hemiarthroplasty (UCH) in patients with femoral neck fractures (FNF). The study included 158 patients aged ≥76 years who underwent bipolar HA for displaced FNF. Patients were randomized in two groups: the cemented group (CHA, n=79) was treated with cement and the uncemented group (UCH, n=79) without cement. The groups were compared for operating time, blood loss and peroperative morbidity and mortality rates. Both the CHA and the UCH group did not differ significantly in terms of age (86±5 vs. 84±4 years), sex (58.3% male vs. 60.7% female), and comorbidities (p=0.49). The CHA group had a significantly longer operating time (p=0.038) and a greater intraoperative blood loss (p=0.024). In the CHA group there were 8 (10.1%) events of intraoperative drop in the oxygen saturation (SaO2), whereas no such events were noted in the UCH group (p=0.009). Despite no significant difference between these two groups, we found that the CHA group was associated with a higher early postoperative mortality (8.8% in the CHA group versus 3.8% in the UCH group, p=0.009). Intraoperative fracture occurred in two patients (2.5%) of the UCH group. Over a 2-year follow-up period there were no significant differences between the groups regarding the rate of dislocation (p=0.56) or rate of postoperative periprosthetic fracture (p=0.56). There was a trend towards a better postoperative functional recovery at 6 week for the CHA group (77.1±13.1 versus 71.3±16.3), although the mean Harris Hip Score (HHS) at the end of 2 years was comparable (p=0.55). Both CHA and UCH are acceptable methods for treating displaced femoral neck fractures. However, based on our results perioperative cardiovascular disturbances are less frequent and resulting in a potential lower early mortality with UCH. Therefore, UCH is particularly appropriate for elderly patients with pre-existing cardiovascular comorbidities. Level II, Randomized Controlled Trial.

Comparison of functional outcomes between cemented and uncemented bipolar hemiarthroplasty for intracapsular neck femur fractures

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The neck of femoral fracture is common and leading fracture in orthopaedic practice. The older age group and female are more to prone to develop this fracture.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A prospective, clinical observational, analytical comparative study was undertaken in the department of Orthopaedics of Geetanjali Medical College and Hospital in Udaipur, Rajasthan from January 2018 to June 2019. 52 adult patients with neck of femur fracture, 26 patients in each group. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In our study, the mean age was 77.72 years. Female preponderance was seen in our study. In our study mean duration of surgery in uncemented group was 65.78 minutes and mean duration of surgery in cemented group was 79.89 minutes. The mean total HHS in our patient was 86.63 with standard deviation of 6.18. Mean HHS for cemented group was 86 and for uncemented group was 87.23. We found 20 excellent result and 27 good results (35.71% and 51.92% respectively). We also found 5 fair result (12.37%). There were 2 complications, both in cemented group, one had post-operative dislocation and other had a cement reaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Both cemented and uncemented hemiarthroplasty are equally good options in the treatment of femoral neck fractures in the elderly. However, it is to be noted that the duration of surgery &amp;amp; complications, were both less in the uncemented group as compared to cemented hemiarthroplasty group in our study. &lt;/p&gt;

Cemented or uncemented bipolar hemiarthroplasty for femoral neck fractures in aged patients

Background: In aged patients, a femoral neck fracture is the most common hip fracture injury and most commonly treated with bipolar hemiarthroplasty. The available data on the outcomes of cemented bipolar hemiarthroplasty or uncemented bipolar hemiarthroplasty in terms of functional parameters is scant. Hence we had evaluated the functional outcomes in a femoral neck fracture patients treated with either cemented bipolar hemiarthroplasty or uncemented bipolar hemiarthroplasty. Material and Methods: About 120 aged patients who had a femoral neck fracture, constituted the total sample size. Out of which 60 aged patients were treated with cemented bipolar hemiarthroplasty and rest 60 patients were treated with uncemented bipolar hemiarthroplasty. The patients were followed up at 3rd, 6th and 12th postoperative months.Results: The mean age was 69.83 years in cemented bipolar hemiarthroplasty group and 69.6 years in uncemented bipolar hemiarthroplasty. The Harris Hip Score was 90.2 in cemented bipolar hemiarthroplasty group and 87.9 in uncemented bipolar hemiarthroplasty group. Our study show more blood loss in the cemented bipolar hemiarthroplasty group while more implant-related complications in an uncemented bipolar hemiarthroplasty group. The follow up rate was 100% in our study. Conclusion: This study was able to show that cemented bipolar hemiarthroplasty had a good functional outcome.

Cemented vs uncemented bipolar hemiarthroplasty in neck of femur fractures: A case series of 90 patients

Introduction: The purpose of our study was to compare results of cemented vs cementless bipolar hemiarthroplasty in fractures of neck of femur with regards to functional outcome, operative time, pain, blood loss and complications.Materials and Methods: Ninety patients with displaced femoral neck fracture operated with bipolar hemiarthroplasty were enrolled in this study and their medical records were reviewed. 35 patients had undergone uncemented bipolar hemiarthroplasty and 55 had undergone cemented bipolar hemiarthroplasty. Post-operative status of the patients was assessed using Harris Hip Score (HHP) and Visual Analogue Score (VAS). Patients were reviewed after one year of surgery at 6 wks interval. Results: Mean operation and bleeding times were longer in the cemented group compared to the uncemented group. The mean pain score was significantly less in the cemented group compared to the uncemented group. Hip functional outcome based on HHS was more in the cemented group. The intraoperative and postoperative complication rate was higher in the uncemented group.Conclusion: Although higher rates of intraoperative bleeding and longer surgery time were seen with cemented bipolar hemiarthroplasty in patients with femoral neck fracture compared to uncemented bipolar hemiarthroplasty, cemented bipolar hemiarthroplasty is better because of better functional outcome and less residual pain.

Study of functional outcome of unipolar and bipolar hemiarthroplasty in fracture neck of femur

Study of functional outcome of unipolar and bipolar hemiarthroplasty in fracture neck of femur - IJOS- Print ISSN No: - 2395-1354 Online ISSN No:- 2395-1362 Article DOI No:- 10.18231/j.ijos.2019.013, Indian Journal of Orthopaedics Surgery-Indian J Orthop Surg

A short term prospective study of the functional outcome of uncemented bipolar hemiarthroplasty in displaced fracture neck of femur in elderly

Fractures of the hip is emerging as a commonly encountered fracture in the older individuals. Among the proximal femur fracture, neck of femur constitutes around 50%. Treatment goals for fracture neck of femur are aimed at early return to a satisfactory functional status to pre-injury ambulatory status. Bipolar hemiarthroplasty has emerged as good surgical option for pre-morbid active elderly patients. We are presenting a prospective study of the functional outcomes of uncemented bipolar hemiarthroplasty in displaced fracture neck of femur in the elderly. This study was conducted at Sree Balaji Medical College and Hospital, Chromepet Chennai from June 2015 to May 2018. A total of 25 patients were recruited for this study aged between 61 to 75 years. Based on Singh’s index and Dorr’s Classification of femoral canal ratio, idealy suited patients were selected for uncemented bipolar hemiarthroplasty. Functional outcomes of the patients were evaluated using the Harris Hip Score. All the cases were followed up for a minimum of 12 months and we had 88% of excellent to good results in our study and there were no poor outcomes. Uncemented bipolar hemiarthroplasty avoids the complications of cementing in the elderly, and preserves the bone for a later THR if needed. Also they reduce the risk of acetabular erosion and protrusion. We conclude that bipolar uncemented hemiarthroplasty produce good functional outcome with minimum complications for carefully selected displaced intra-capsular femoral neck fractures in the elderly.

Intraoperative periprosthetic femur fracture during bipolar hemiarthroplasty for displaced femoral neck fractures.

We aim to review the incidence and risk factors for the development of intraoperative periprosthetic femur fractures while performing a bipolar hemiarthroplasty for displaced neck of femur fractures. Our secondary aim is to characterize the types of intraoperative periprosthetic fractures, the steps leading to the fractures, and the salvage treatments instituted. 271 patients treated with bipolar hemiarthroplasty after traumatic displaced femoral neck fractures were retrospectively analyzed. Demographic data, co-morbidities, vitamin D level, consumption of steroids, ASA score, surgical approach, surgeon experience, use of cemented or uncemented implants, proximal femur morphology, and types of anaesthesia were analyzed statistically. There were 28 patients (10.3%) with intraoperative periprosthetic femur fractures. We found two significant independent risk factors which were the use of uncemented prosthesis (OR 4.15; 95% CI 1.65-10.46; p = 0.003) and Dorr type C proximal femurs (Dorr A OR 3.6; 95% CI 1.47-8.82; p = 0.005). In addition, patients with Dorr type C proximal femurs who underwent uncemented bipolar hemiarthroplasty were more likely to sustain an intraoperative periprosthetic fracture (14(73.7%) out of 19 patients; p = 0.002). There were no significant differences found in other risk factors. The most common location for these fractures was at the greater trochanter at 11 (39.3%) cases. Majority of them, 15 (53.6%), had intraoperative fractures during trial implant insertion and reduction. The overall incidence of intraoperative periprosthetic femur fractures during hemiarthroplasty for displaced neck of femur fractures was 10.3%. The incidence was significantly higher for uncemented (14.7%) when compared to cemented prosthesis (5.4%) and the greater trochanter was the commonest area for periprosthetic fractures during trial implant insertion and reduction. Uncemented prosthesis and Dorr type C proximal femurs were two significant independent risk factors contributing to intraoperative periprosthetic fractures. By identifying these risk factors, surgeons can take ample precautions to prevent complications.

Cemented versus uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; This study compared functional outcome and results between cemented and uncemented bipolar hemiarthroplasty in patients older than 60 years with displaced femoral neck fracture.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Total fifty four patients with displaced femoral neck fracture were enrolled in this study. Out of total twenty eight patients underwent uncemented bipolar hemiarthroplasty and remaining twenty six patients underwent cemented bipolar hemiarthroplasty. Physical examination and radiographs were performed at the first and sixth months after operation and results were recorded. The patient’s pain and functions were evaluated with visual analogue scale and Harris Hip Score&lt;strong&gt; &lt;/strong&gt;and then compared to each other.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; All patients were followed up for at least 6 months. Mean operation and bleeding times were longer in cemented group compared to the uncemented group (p&amp;gt;0.05). The mean pain score was significantly less in the cemented group compared to the uncemented group (p=0.001). Hip functional outcome based on HHS was more in the cemented (p=0.001). The intraoperative and postoperative complication rate was higher in the uncemented group (p&amp;lt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Although higher rates of intraoperative bleeding and surgery time were seen with cemented bipolar hemiarthroplasty in older patients with femoral neck fracture compared to uncemented bipolar hemiarthroplasty, cemented bipolar hemiarthroplasty can cause less complication and improve patient’s function in less time. &lt;/p&gt;

Evaluation of Risk Factors for Second Hip Fractures in Elderly Patients.

BackgroundHip fracture is a worldwide public health problem that primarily affects osteoporotic individuals and the elderly. A second hip fracture can occur in elderly patients who have already suffered an initial hip fracture. The aim of this study was to investigate possible risk factors for second hip fractures in elderly patients with hip fractures.MethodsBetween 2010 and 2014, 230 patients who underwent uncemented bipolar hemiarthroplasty for hip fractures were retrospectively analyzed. The patients were divided into two groups: those with a first hip fracture (group 1) and those with a second hip fracture (group 2).ResultsThe mean time from the first hip fracture to second hip fracture was 22 months. There were no significant differences in the American Society of Anesthesiologist scores, comorbidities were observed in the two groups. The mean length of hospitalization was not significantly different between the two groups. The mean postoperative functional scores after second hip fractures were significantly lower in group 2 than in group 1.ConclusionsAlthough there are not certain risk factors for second hip fractures in elderly patients with hip fractures, to prevent second hip fractures, elderly patients should be provided with physical and medical therapy as well as orthotic support and their functional activity should be maintained.

Comparison between cemented and un-cemented hemiarthroplasty among the patients with fracture neck of femur

Background: Hemiarthroplasty has been accepted as the treatment of choice for displaced femoral neck fractures. In the recent years the use of bone cement in hemiarthroplasty had become a controversial topic as few studies had recommended the use of uncemented hemiarthroplasty because of its minimal complications. Aim: To compare and assess the efficacy of cemented and uncemented bipolar hemiarthroplasty prosthesis among patients with femoral neck fractures. Methodology: A prospective comparative study was conducted at our hospital from the department of Orthopaedics for a period of one year. Patients aged more than 18 years of age of any gender with fracture neck of femur were included as study subjects. A total of 60 patients were included as our study subjects. It was divided into two groups of 30 each, one group received the cemented and the other group underwent an uncemented hemiarthroplasty. Patients were followed up on the 6th postoperative week for radiological assessment of the implant position and further advised for complete weight bearing as tolerated. Subsequently patients were followed up at 3rd and 12th month. At each visit patient was assessed for recovery based on harris hip score which includes post operative pain, return to activities of daily living, shortening of limb, range of movements, deformity and gait. Results: The duration of surgery was found to be longer in the cemented group with a mean duration of 82.8 mins and among the un-cemented group it was 63.6 mins. The intra-operative blood loss in 60% of the patients among the cemented group had more than 300 ml whereas among the un-cemented group it was only 13.3% had more than 300 ml of blood loss. The mean Harris hip score at the end of 12 months among the cemented group was 81.6 and among the un-cemented group it was 79.07 and both the groups showed a statistical significant improvement in their scores when compared to the score at 3 months whereas no significant difference observed in the scores between the two groups. Conclusion: Both the cemented and uncemented hemiarthroplasty are equally good options in the treatment of fracture neck of femur among elderly patients with minimal complications among the two methods. More data comparing uncemented and cemented hemiarthroplasty in patients with femoral neck fracture are still needed to substantiate our findings.