Early dislocation after bipolar hemiarthroplasty of the hip. The operation is similar to a total hip replacement but it involves only half of the hip. The use of internal fixation, bipolar hemiarthroplasty and uncemented. Unlike total hip replacement, in which both the ball of the femur and the hip socket are replaced, in this procedure, only the ball is replaced. Hip hemiarthroplasty bipolar orthopedic associates of. In the treatment of older patients with displaced femur neck fracture, bipolar hemiarthroplasty bha is a more commonly accepted treatment, compared with internal fixation, because this modality offers advantages. This study compared the rates of mortality, medical complication, and reoperation after fixation surgery for displaced femoral neck fracture with those after hemiarthroplasty surgery for undisplaced femoral neck fracture using competing risk analysis in inpatients aged 60 years and above from a population database in taiwan. In a previous oneyear followup of an rct from our department including 120.
Hip hemiarthroplasty ha following an intracapsular neck of femur fracture is an. Hip hemiarthroplasty has proven to be an effective treatment for displaced femoral neck fractures for more than 50 years, with low incidence rates of infection and dislocation. Methods one hundred and twenty patients aged 80 or more with a displaced fracture of the femoral neck garden iii and. Is cemented bipolar hemiarthroplasty a safe treatment for femoral neck fracture in elderly patients. We are documenting the manufacturer, implant material and bearing surface of the implant. Difference between bipolar and unipolar bipolar vs unipolar. The possible advantages of a bipolar ha are a better range of motion and less acetabular wear. Seven weeks later, while getting out of bed, he sustained a posterior dislocation of the hemiarthroplasty with simultaneous dissociation between the polyethylene cup and the prosthetic ball head, with both items out off the acetabulum. Majority of the patients had a pain free mobile hip, with full range of. The purpose of this study is to compare unipolar and bipolar hemiarthroplasty as a treatment for patients aged 70 years or above with a dislocated medial femoral neck fracture.
Article information, pdf download for steady state acetabular cartilage wear after bipolar. In a unipolar hemiarthroplasty only the prosthetic femoral head articulates in the acetabulum, only one point of movement uni 1 in a bipolar hemiarthroplasty there are. By the end of the cold war, bipolar international system disintegrated. Hemi means half, and arthroplasty means joint replacement. Dislocation and dissociation of bipolar hip hemiarthroplasty. Comparison of hemiarthroplasty and total hip arthroplasty. Jul 14, 2016 bipolar or hemiarthroplasty is a surgical procedure which replaces one half of the joint with an artificial surface and leaves the other part in its natural preoperative state. Bipolar hemiarthroplasty for femoral neck fracture using the direct. Mbbs singapore, mrcs edinburgh mrcs edinburgh, mmed. Among these procedures, hemiarthroplasty has become the most preferred treatment option for surgeons according to the surveys. The guest edited thematic issues are published free of charge.
The united states has become the only superpower and the international system has become unipolar waltz, 1999. The decision to perform hemiarthroplasty using a unipolar or bipolar prosthesis remains controversial, with proponents on either side. Bipolar disorder is characterized by cyclic depressive as well as manic or hypomanic episodes, but the depressive phase of the bipolar disorder appears identical to unipolar depression. Collapse of the soviet union led to the relative absence of balance of power competition. The optimal design, unipolar or bipolar head, remains unclear. Nov 11, 2015 inngul c, hedbeck cj, blomfeldt r, lapidus g, ponzer s, enocson a. Between 2008 and 2010, 81 patients with femoral neck fracture underwent bha using the direct anterior approach daa or the. Hip fracture evaluation with alternatives of total hip. Letter to the editor regarding unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures. Performing a hemiarthroplasty rather than a total hip arthroplasty in our defined patient population may put the patient at a higher risk for morbidity and future complications. Full text is cemented bipolar hemiarthroplasty a safe.
Introductioncartilage wear is a concern after hemiarthroplasty. Hemiarthroplasty unipolar and bipolar indications approach and procedure moderator. Hemiarthroplasty of the hip is one of the surgical treatments for femoral neck fractures, replacing the head due to the high risk of posttraumatiic avascular necrosis. A recent metaanalysis of rcts comparing unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures did not fi nd an advantage of bipolar prostheses jia 2015. A metaanalysis chen jiangtao1, zhou yijun2, xun chuanhui1, huo jianjun3, song xinghua1, tian zheng1, akbar yunus1, cao li1 1orthopaedic department, the first affiliated hospital of xinjiang medical university, urumqi 2orthopaedic department, the first peoples. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for. Unipolar vs bipolar hemiarthroplasty dennis zw ng and kevin bl lee 198 materials and methods all patients who underwent hemiarthroplasty for displaced neck of femur fractures between 1 january 2004 and 31 december 2007 were analysed from a log of all operative procedures.
Mar 16, 2018 hemiarthroplasty ha is an effective procedure for treatment of femoral neck fracture. Tidermarkunipolar hemiarthroplasty versus bipolar hemiarthroplasty in the most elderly patients with displaced femoral neck fractures. Someone with unipolar depression doesnt go through the highs of bipolar depression. Rona hu discusses the probabilistic approach to diagnosing unipolar vs. The purpose of this study was to compare the causes of failure and longevity in both types of ha. Letter to the editor regarding unipolar versus bipolar.
It can allow considerable improvement in pain and disability for the patient and has become one of the most successful innovations in modern medicine. Bipolar versus unipolar hemiarthroplasty for patients with a. It has been noted that patients undergoing hemiarthroplasty for fracture of the hip can indeed experience compromised. Unipolar depression is a mental disorder that results in a patient having episodes of lowmood, low selfesteem, loss of interest, loss of pleasure in enjoyable activities. Displaced femoral neck fractures fnfs in healthy elderly patients have traditionally been managed with hemiarthroplasty ha or total hip arthroplasty tha, with studies suggesting that tha may be the better option. Each of these two modalities has specific advantages and understanding the difference between the two can help you understand the differences in how theyre used. Current concepts of etiological factors and management. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the most elderly patients with displaced femoral neck fractures. However, it has recently been reported that bipolar ha bha also provides good outcomes, and it is not clear as to whether bha or tha is most appropriate. Sep 10, 2017 the femoral head can be replaced two 2 different ways, either as unipolar or bipolar. In this lesson, we will explore the difference between bipolar and unipolar depression and the symptoms of each. To the best of our knowledge, this is the first rct that systematically analyses acetabular erosion after unipolar ha and bipolar ha using a modern hemiarthroplasty.
The treatment of choice for a displaced femoral neck fracture in the most elderly patients is a cemented hemiarthroplasty ha. The aim of this study was therefore to assess the dislocation rate after bipolar hemiarthroplasty of the hip. Pdf uni and bipolar hemiarthroplasty with a modern cemented. Hip hemiarthroplasty unipolar versus bipolar hip hemiarthroplasty in the treatment of femoral neck fractures in the elderly ali a. Displaced femoral neck fractures fnfs in healthy elderly patients have traditionally been managed with hemiarthroplasty ha or total hip. Hemiarthroplasty, harris hip scor, intertrochanteric fractures. However, which type is best for treating displaced femoralneck fractures in elderly patients remains a subject for debate. Sign in here to access free tools such as favourites and alerts, or to. A person may start of being happy and then go quickly to becoming sad or depressed. Comparative study of bipolar hemiarthroplasty for femur neck. There are important differences between unipolar depression and bipolar depression differences in how the illness makes people feel and behave, and differences in how they are supported through treatment.
Pdf unipolar versus bipolar hemiarthroplasty for displaced. To study the functional outcome of primary cemented bipolar. Comparison of bipolar hemiarthroplasty and total hip. We did not standardise the choice of modular unipolar versus bipolar ha nor whether implants are inserted with cement or with a pressfit design. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures. Metaanalysis of randomised controlled trials comparing. Unipolar versus bipolar hemiarthroplasty for displaced. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoralneck fractures. This article discusses the use of both unipolar and bipolar prostheses for treatment of femoral neck fractures in. The large prosthetic head can be removed and a smaller one. Outcome of hemiarthroplasty and total hip replacement for. However, this proposed decreased rate of dislocation has been challenged. The secondary aim was to analyse the degree of acetabular erosion and its influence upon outcome. The most commonly used unipolar and bipolar implant heads were the mega caput in sweden, recently renamed link unipolar.
A male 75yearold patient was treated with a bipolar hemiarthroplasty zweymuller after a subcapital fracture of his right femur. Unipolar or bipolar free download as powerpoint presentation. May 21, 2015 hip joint replacement hip arthroplasty is the surgical replacement of all, or part, of the hip joint with an artificial device. The aim of this study was to evaluate hip function, health related quality of life hrqol, surgical outcome. Electrosurgery makes use of highfrequency electrical current to cut, coagulate, desiccate, and fulgurate tissue and can be performed using either monopolar or bipolar energy in conjunction with a specialized instrument. The femoral head can be replaced two 2 different ways, either as unipolar or bipolar. Despite stark statistics outlining the consequences of misdiagnosis, differentiating unipolar depression from bipolar disorder can be challenging. Hip hemiarthroplasty an overview sciencedirect topics. Hemiarthroplasty or total hip arthroplasty in recent. Bipolar unipolar lower cost simpler bipolar less wear more modular more expensive can dissociate can convert to total hip arthroplasty. We searched databases including pubmed central, medline from 1966, embase from 1980 and the cochrane central register of controlled trials database. Factors that could play a role in decisionmaking include patient age, activity level, and associated medical conditions. A suggested advantage of the bipolar design is improved stability of the prosthesis and resistance to dislocation.
Only prospective randomized controlled trials rcts. The hemiarthroplasty replaces only the ball portion of the hip joint, not the socket portion. Good postoperative results of hip hemiarthroplasties in patients with below knee amputations have been reported in the past, with a return of the patients to their preoperative level of daily life activity 1, 2. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly. Hemiarthroplasty is a common procedure in the treatment of femoral neck fractures in the elderly. If you or someone you know is experiencing these symptoms, its important to visit your counseling center or a mental health professional to get the right diagnosis and treatment. The choice between unipolar and bipolar hemiarthroplasty for treatment of displaced intracapsular femoral neck fractures. The hip coxofemoral joint is a large and stable diarthroidal ballandsocket joint formed by the articulation between the femoral head and the. Dissociation of bipolar hemiarthroplasty of the hip after. Bipolar depression is frequently misdiagnosed as unipolar depression in outpatient 28 and inpatient 9 settings, and in children and adolescents. Unipolar versus bipolar hemiarthroplasty 7 subjects and methods the present study is of intracapsular fracture neck of femur in elderly patients above the age of 60 years, irrespective of gender, treated with hemiarthroplasty using uncemented unipolar austin moores prosthesis amp in 20 patients and. Jul 31, 2009 hip hemiarthroplasty is a common procedure for the treatment of subcapital femoral fractures.
Dislocation after bipolar hemiarthroplasty in patients with. The poly is packaged inside the shell so first thing to do is to use liner release forceps to remove liner from shell then place poly insert on head. There are two types of options, including unipolar hemiarthroplasty uh and bipolar hemiarthroplasty bh, when using a hemiarthroplasty. W is typical of patients who have what we consider a bipolar spectrum disorder and receive an inaccurate diagnosis and treatment that is ineffective or may worsen the course of their illness. However, the optimal treatment choice remains controversial. Sep 04, 2008 unipolar or bipolar hemiarthroplasty in the treatment of displaced femoral neck fractures. Untreated basotrochanteric fracture of one month duration. Outcomes after fixation for undisplaced femoral neck fracture. Hemiunibipol the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
Thompson hemiarthroplasty for femoral neck fracture is. Inngul c, hedbeck cj, blomfeldt r, lapidus g, ponzer s, enocson a. Bipolar hip hemiarthroplasty in a patient with an above knee. Jan 24, 2015 whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty uh remains controversial. Bipolar results from disturbances in the areas of the brain that regulate mood it involves periods of excitability mania alternating with periods of depression this may affects men and women equally usually appears between ages 15 25 cause unknown it occurs more often in relatives of people with bipolar disorder, if you believe you have bipolar you might want to visit somewhere like. A hemiarthroplasty is an operation that is used most commonly to treat a fractured hip. Free the abductor muscles by osteotomizing the greater trochanter. When you hear people talk about being diagnosed with or treated for depression, they are often referring to unipolar depression. Stahl describes ways to distinguish whether a patient may have unipolar or bipolar disorder. The american society of anesthesiologists asa score was used to evaluate the patients preoperative general health condition, and the charlson comorbidity index was used to determine the effect of additional diseases on the results. Physical therapy in seattle for hip surgery hemiarthroplasty.
A systematic literature search up to april, 2014 was conducted to include rcts comparing bh with uh for. Comparison of bipolar hemiarthroplasty with cemented vs. In the hemiarthroplasty group, the bipolar prosthesis usually had a better result than the unipolar prosthesis. Unipolar versus bipolar hemiarthroplasty 7 subjects and methods the present study is of intracapsular fracture neck of femur in elderly patients above the age of 60 years, irrespective of gender, treated with hemiarthroplasty using uncemented unipolar austin moores prosthesis amp in. Proposed advantages of the bipolar prosthesis include less acetabular wear and potentially less hipgroin pain. Unipolar or bipolar mania major depressive disorder. In a total hip replacement the socket is also replaced. Typically indicated patients include the elderly with displaced femoral neck fractures without osteoarthritis and the medically infirm for whom the additional risks of a total hip replacement do not outweigh the. This video describes one of the most commonly done procedures for displaced fractures of femoral neck in elderly. Surgical technique selfcentering bipolar and modular cathcart unipolar endo heads depuy synthes 3 assembly selfcentering bipolar modular cathcart unipolar note. Below is a closer look at the symptoms of both depression and mania. Comparison of hemiarthroplasty and total hip arthroplasty in elderly. Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures. Surgical information and postoperative outcomes were analyzed.
Insertion of a hemiarthroplasty is a well established treatment for a dislocated medial hip fracture in elderly patients. Unipolar or bipolar prosthesis for displaced intracapsular hip fracture in octogenarians. Is there a significant difference in surgery and outcomes. Unipolar or bipolar hemiarthroplasty for femoral neck fractures in the elderly. Bipolar hemiarthroplasty offers a durable and versatile solution for unstable. Bipolar disorder is a condition in which people experience extensive mood swings. How to differentiate bipolar disorder from unipolar. Unipolar or bipolar hemiarthroplasty in the treatment of. This surgical procedure replaces the head of a damaged femur with an implant designed to stabilize the femur and restore hip function. Unipolar and bipolar hemiarthroplasty ha are used to treat displaced femoralneck fractures. Unipolar versus bipolar hip hemiarthroplasty in the treatment.
Pdf comparison of bipolar hemiarthroplasty and total hip. Unipolar versus bipolar hip hemiarthroplasty in the. A total of 10 rcts including 1,190 patients were indentified. Unipolar vs bipolar hemiarthroplastydennis zw ng and kevin bl lee 198 materials and methods all patients who underwent hemiarthroplasty for displaced neck of femur fractures between 1 january 2004 and 31 december 2007 were analysed from a log of all operative procedures. Changes in implant choice and surgical technique for. In a unipolar hemiarthroplasty only the prosthetic femoral head articulates in the acetabulum, only one point of movement uni 1 in a bipolar hemiarthroplasty there are two points of movement bi 2. Hemiarthroplasty ha is an effective procedure for treatment of femoral neck fracture. In this study, a bipolar component was used in 90% of the patients undergoing hemiarthroplasty and a monopolar component for the other 10% of the patients. To the best of our knowledge, this is the first rct that systematically analyses acetabular erosion after unipolar ha and bipolar ha using a modern hemiarthroplasty with identical stems in both groups. Unipolar and bipolar stepper motors microchip technology. There was an increased rate of acetabular erosion among the patients with unipolar hemiarthroplasties at the early followups with a significant difference at 12 months unipolar has 20 % and bipolar has 5 %, p0. Advantages of the unipolar prosthesis include lower cost and no risk of polyethylene wear debris. Whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty uh remains controversial.
Unipolar versus bipolar hemiarthroplasty for displaced femoral neck. Bipolar hemireplacement arthroplasty for femoral neck. Tight fit bipolar hip arthroplasty in avn hip in young adults by baldev dudani. At the later followups the incidence of acetabular erosion accelerated in the bipolar. This prosthesis is a bipolar hemiarthroplasty which can be converted to a total hip arthroplasty in the future. All operations were performed through an anterolateral approach. Raia fj, chapman cb, herrera mf, schweppe mw, michelsen cb, rosenwasser mp. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty. The choice between unipolar and bipolar hemiarthroplasty for treatment of displaced intracapsular. Download as ppt, pdf, txt or read online from scribd. To assess the safety and efficacy that compare bipolar hemiarthroplasty with unipolar hemiarthroplasty for the treatment of femoral neck fracture in the patient aged more than 65 years. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in. Background displaced fracture of the femoral neck has been a common clinical problem, especially in aged patients.
919 808 1120 877 1391 1630 67 777 490 1412 111 938 196 982 602 677 1216 995 680 159 911 128 1394 199 1252 902 663 329 29 685