Han-Jun Lee; Jong Won Kim; Jae-Sung Lee; Jae June Yang; Woo-Young Hwang

doi:10.12671/jkfs.2010.23.3.276

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Original Article
Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients: Han-Jun Lee, M.D., Jong Won Kim, M.D., Jae-Sung Lee, M.D., Jae June Yang, M.D., Woo-Young Hwang, M.D.; Journal of the Korean Fracture Society 2010;23(3):276-281.
DOI: https://doi.org/10.12671/jkfs.2010.23.3.276
Published online: July 31, 2010

Department of Orthopedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

^*Department of Orthopedic Surgery, Hanil General Hospital, Seoul, Korea.

Address reprint requests to: Jong Won Kim, M.D. Department of Orthopedic Surgery, Hanil General Hospital, 388-1, Ssangmun-dong, Dobong-gu, Seoul 132-703, Korea. Tel: 82-2-901-3078, Fax: 82-2-900-1745, osjongwoni@hotmail.com

• Received: April 9, 2010 • Revised: May 17, 2010 • Accepted: June 15, 2010

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Abstract
REFERENCES

Abstract

Purpose
To evaluate clinicoradiological outcomes after cementless bipoloar hemiarthroplasty in elderly patients with femoral intertrochanteric fractures.
Materials and Methods
From March 2006 to February 2008, 28 patients-all in patients greater than 80 years of age, classified unstable intertrochanteric fractures in Evans classification-were followed for more than 1 year. 24 patients were women and 4 patients were men. The mean age of the patients was 84.6 years, the mean follow-up period was 16.3 months. Harris hip score, postoperative inguinal and thigh pain, Parker and Palmer mobility score were analyzed clinically. The radiological results were assessed using various radiological indicies including bone-union, fit and alignment change of femoral stem and vertical subsidence.
Results
The average Harris hip score was 82.9, Parker and Palmer mobility score preoperative 8.0 changed to 5.2 postoperatively. More than moderate pain was presented in 1 case. There were no cases of varus deformity or osteolysis. All stems were stable without significant alignment change or subsidence except 1 case of periprosthetic fracture. There were no dislocation, thromboembolism, death during operation or hospital days.
Conclusion
In elderly patients, cementless bipolar hemiarthroplasty is good treatment method of unstable intertrochanteric fracture and short-term clinicoradiological outcomes proved to be satisfactory.
Key words: Unstable intertrochanteric fracture, Cementless bipolar hemiarthroplasty

REFERENCES

1. Berend KR, Lombardi AV, Mallory TH, Dodds KL, Adams JB. Cementless double-tapered total hip arthroplasty in patients 75 years of age and older. J Arthroplasty, 2004;19:288-295.
2. Boldin C, Seibert FJ, Fankhauser F, Peicha G, Grechenig W, Szyszkowitz R. The proximal femoral nail (PFN)-a minimal invasive treatment of unstable proximal femoral fractures: a prospective study of 55 patients with a follow-up of 15 months. Acta Orthop Scand, 2003;74:53-58.
3. Crowninshield RD. Design considerations to reduce stress shielding. Total Hip: Cement vs. Cementless. Harris Hip Course, 1984.
4. Dandy DJ. Fat embolism following prosthetic replacement of the femoral head. Injury, 1971;3:85-88.
5. Engh CA, Bobyn JD. Engh CA, Bobyn JD. Clinical evaluation of biological fixation. In: Biological fixation in total hip arthroplasty, 1985;Thorofare, NJ, Slack Inc. 219-240.
6. Evans EM. The treatment of trochanteric fractures of the femur. J Bone Joint Surg Br, 1949;31B:190-203.
7. 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;71:1214-1255.
8. Haidukewych GJ, Berry DJ. Hip arthroplasty for salvage of failed treatment of intertrochanteric hip fractures. J Bone Joint Surg Am, 2003;85-A:899-904.
9. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fracture:. treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am, 1969;51:737-755.
10. Huiskes R, Chao EY. A survey of finite element analysis in orthopedic biomechanics: the first decade. J Biomech, 1983;16:385-409.
11. Hungerford DS, Jones LC. The rationale for cementless total hip replacement. Orthop Clin North Am, 1993;24:617-626.
12. Hwang DS, Jung HT, Kim SB, SB JS. Recovery of walking ability after operation for unstable intertrochanteric fractures in of the Femur in Elderly. -Timing on weight Bearing-. J Korean Soc Fract, 1998;11:296-303.
13. Kang JS, Dorr LD, Wan Z. The effect of diaphyseal biologic fixation on clinical results and fixation of the APR-II stem. J Arthroplasty, 2000;15:730-735.
14. Khan RJK, MacDowell A, Crossman P, et al. Cemented or uncemented hemiarthroplasty for displaced intracapsular femoral neck fractures. Int Orthop, 2002;26:229-232.
15. Kim YH. Bilateral cemented and cementless total hip arthroplasty. J Arthroplasty, 2002;17:434-440.
16. Lettich T, Tierney MG, Parvizi J, Sharkey PF, Rothman RH. Primary total hip arthroplasty with an uncemented femoral component: tow- to seven-year results. J Arthroplasty, 2007;22:7 Suppl 3. 43-46.
17. McAuley JP, Moore KD, Culpepper WJ 2nd, Engh CA. Total hip arthroplasty with porous-coated prostheses fixed without cement in patients who are sixty-five years of age or older. J Bone Joint Surg Am, 1998;80:1648-1655.
18. Parker MJ, Palmer CR. A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg Br, 1993;75:797-798.
19. 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.
20. Rothman RH, Cohn JC. Cemented versus cementless total hip arthroplasty. A critical review. Clin Orthop Relat Res, 1990;254:153.
21. Yoo MC, Kim KT, Cho YJ, Sun SD, Park GC. Treatment of femur neck and intertrochanteric fractures in the elderly with primary hemiarthroplasty. J Korean Soc Fract, 1994;7:412-421.

Fig. 1

The displaced greater trochanteric fragments were fixed with non-absorbable suture material.

Fig. 2

The fragment of femoral neck replace the lesser trochanteric fragment with wiring.

Fig. 3

(A) Preoperative radiograph of a 71-year-old female shows unstable intertrochanteric fracture.

(B) Immediate postoperative radiograph shows bipolar arthroplasty state.

(C) Radiograph at postoperative 1 year shows stable fixation.

Table 1

The results of HHS^*, P&P score^†, fit of femoral stem and vertical subsidence

^*HHS: Harris hip score, ^†P&P score: Parker and Palmer mobility score.

Figure & Data

REFERENCES

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The Comparison of Compression Hip Screw and Bipolar Hemiarthroplasty for the Treatment of AO Type A2 Intertrochanteric Fractures
Yee-Suk Kim, Jae-Seung Hur, Kyu-Tae Hwang, Il-Yong Choi, Young-Ho Kim
Hip & Pelvis.2014; 26(2): 99. CrossRef

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Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients

J Korean Fract Soc. 2010;23(3):276-281. Published online July 31, 2010

DOI: https://doi.org/10.12671/jkfs.2010.23.3.276

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Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients

Fig. 1 The displaced greater trochanteric fragments were fixed with non-absorbable suture material.

Fig. 2 The fragment of femoral neck replace the lesser trochanteric fragment with wiring.

Fig. 3 (A) Preoperative radiograph of a 71-year-old female shows unstable intertrochanteric fracture. (B) Immediate postoperative radiograph shows bipolar arthroplasty state. (C) Radiograph at postoperative 1 year shows stable fixation.

Fig. 1

Fig. 2

Fig. 3

Cementless Bipolar Hemiarthroplasty for Treating Intertrochanteric Fracture in Elderly Patients

Table 1

The results of HHS^*, P&P score^†, fit of femoral stem and vertical subsidence

^*HHS: Harris hip score, ^†P&P score: Parker and Palmer mobility score.

Table 1 The results of HHS*, P&P score†, fit of femoral stem and vertical subsidence

^*HHS: Harris hip score, ^†P&P score: Parker and Palmer mobility score.