Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2007 Feb;42(1):53-58. Korean.
    Published online Feb 28, 2007.
    https://doi.org/10.4055/jkoa.2007.42.1.53
    Copyright © 2007 The Korean Orthopaedic Association
    Original Article

    Cemented Bipolar Hemiarthroplasty for the Femoal Neck or Intertrochanteric Fracture in Elderly Patients - Multicenter Study -

    Sang-Rim Kim, M.D., Kwang-Hoon Chung, M.D., Kwang-Bok Lee, M.D., Sung-Rak Lee, M.D.,* Bong-Jin Lee, M.D.,* Jong-Tae Park, M.D.,† and Yong-Chan Ha, M.D.†
      • Department of Orthopaedic Surgery, College of Medicine, Cheju National University, Jeju, Korea.
      • *Department of Orthopaedic Surgery, Halla General Hospital, Jeju, Korea.
      • †Department of Orthopaedic Surgery, College of Medicine, Gyeongsang National University, Jinju, Korea.
    • Address reprint requests to Yong-Chan Ha, M.D. Department of Orthopaedic Surgery, Gyeongsang National University Hospital, 90, Chilam-dong, Jinju 660-702, Korea. Tel: +82.55-750-8107, Fax: +82.55-753-4789, Email: hychan@gaechuk.gsnu.ac.kr

    Abstract

    Purpose

    This multicenter study was carried out to estimate the clinical and radiological results of cemented bipolar endoprosthesis replacement arthroplasty of a hip fracture in patients aged over 50 years in Jeju Island.

    Materials and Methods

    Eighty-eight hips underwent bipolar endoprosthesis in 2002. Thirty-two patients died during the follow-up period and 7 patients refused a radiological evaluation or an interview. Two patients who underwent cementless bipolar endoprosthesis were excluded. Forty-nine hips (48 patients) completed the average 27 months follow-up. A neck fracture was involved in 40 hips (39 patient) and an intertrochanteric fracture was involved in 9 hips (9 patients). The average age was 77.7 years. The results were evaluated using clinical and radiological methods.

    Results

    At the last follow-up, the average Harris hip score was 70.1 and 22 hips (45%), which indicated excellent and good results, respectively. Among the 42 patients with normal activity at the preoperative period, 28 patients were still active at the final follow-up. The number of medical illnesses and the severity of mental deterioration were also associated with the poor Harris hip scores. The pressurization cementing technique was found to be excellent at the radiological evaluation. One femoral stem appeared to have loosened and subsided but there was no revision surgery.

    Conclusion

    The clinical result of the cemented bipolar endoprosthesis in multicenter study showed that the only 45% of patients showed results >good. The major factors influencing the results were the postoperative activity, the number of medical illnesses, and the severity of the mental changes.

    Keywords
    Hip fracture; Cemented bipolar endoprosthesis

    Tables

    Table 1
    Comparison between the Harris Hip Score and the Factors Included in the Statistical Analysis (Multiple Regression Test)

    Table 2
    Comparison between Neck Fracture Group and Intertrochanteric Fracture Group with the Harris Hip Score (Mann-Whitney Test)

    References

      1. Beloosesky Y, Grinblat J, Epelboym B, Hendel D. Dementia does not significantly affect complications and functional gain in elderly patients operated on for intracapsular hip fracture. Arch Orthop Trauma Surg 2001;121:257–260.
      1. Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 1973;55:1629–1632.
      1. Choi IY, Kim YH, Kim BH, Lee HS. Cemented bipolar hemiarthroplasty for the femoral neck or cervicotrochanteric fracture in patients older than 85 years. J Korean Hip Soc 2002;14:83–89.
      1. Garrahan WF, Madden EJ. The long-stem bipolar prosthesis in surgery of the hip. Clin Orthop Relat Res 1990;251:31–37.
      1. Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979;141:17–27.
      1. Kelly AJ, Lee MB, Wong NS, Smith EJ, Learmonth ID. Poor reproducibility in radiographic grading of femoral cementing technique in total hip arthroplasty. J Arthroplasty 1996;11:525–528.
      1. Kim YH, Song SJ, Choi IY. Cemented bipolar hemiarthroplasty for the femoral intertrochanteric fracture in elderly patients. J Korean Hip Soc 1998;10:149–155.
      1. Kim YH, Park KC, An SC, Choi IY. Bipolar hemiarthroplasty using cement for the treatment of intertrochanteric femoral fracture in elders-2 to 5 year results-. J Korean Hip Soc 2001;13:149–155.
      1. Korea National Statistical Office. Expectation of Korean population in the future. 2005. pp. 1-60.
      1. 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;71:1214–1225.
      1. Ha YC, Kim SR, Koo KH, et al. An epidemiological study of hip fracture in Jeju Island, Korea. J Korean Orthop Assoc 2004;39:131–136.
      1. Haidukewych GJ, Israel TA, Berry DJ. Long-term survivorship of cemented bipolar hemiarthroplasty for fracture of the femoral neck. Clin Orthop Relat Res 2002;403:118–126.
      1. Halpin PJ, Nelson CL. A system of classification of femoral neck fractures with special reference to choice of treatment. Clin Orthop Relat Res 1980;152:44–48.
      1. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 1969;51:737–755.
      1. Harris WH, McGann WA. Loosening of the femoral component after use of the medullary-plug cementing technique. Follow-up note with a minimum five-year follow-up. J Bone Joint Surg Am 1986;68:1064–1066.
      1. Mullen JO, Mullen NL. Hip fracture mortality. A prospective, multifactorial study to predict and minimize death risk. Clin Orthop Relat Res 1992;280:214–222.
      1. Park YS, Park YK, Youn SH. Comparison between bipolar hemiarthroplasty and total hip arthroplasty for femoral neck fracture in elderly patients. J Korean Hip Soc 1998;10:156–162.
      1. van Dortmont LM, Douw CM, van Breukelen AM, et al. Outcome after hemi-arthroplasty for displaced intracapsular femoral neck fracture related to mental state. Injury 2000;31:327–331.
      1. Yoon HK, Cho DY, Shin DE, Kang SH. Comparison of functional recovery between internal fixation and hemiarthroplasty in basal intertrochanteric fracture in the over eighties. J Korean Orthop Assoc 2004;39:115–122.
    MeSH Terms
    Aged*
    Arthroplasty, Replacement
    Follow-Up Studies
    Hemiarthroplasty*
    Hip
    Humans
    Neck
    Preoperative Period
    Metrics
    Share
    Tables
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