Hemiarthroplasty for intra-capsular fracture neck of femur in elderly patients: a prospective observational study

Background: Hip fractures in older patients are associated with impaired mobility, excess morbidity and mortality, and loss of independence. This study was aimed at evaluating the outcome of hemiarthroplasty, by assessing the quality of life and degree of function in the operated limb.Methods: Out of 30 patients treated in this manner, all cases were available for follow-up period of 6 months. Patients of age 60 years and above, diagnosed with fracture neck of femur, were included in the study.Results: Majority of patients belongs to age group 60-69 years was 56.7% Females were more common 56.7% than males in the present study. About 13.3% patients sustained the injury due to a fall from a height and 23.3% due to a road traffic accident. About 20 patients (60%) had a stay of less than 20 days in hospital. In our study Harris hip score, at end of six month ranged from 35 to 94.6. At final 6 months follow-up by Harris hip scoring system, 53.33% had excellent result, 33.3% had good results, 16.67% had fair results and 6.67% had poor results. Conclusions: We conclude that hemiarthroplasty for fracture neck of femur is a good option in elderly patients. The mortality and morbidity are not high, operative procedure is simple, complications are less disabling. Early functional results are satisfactory.

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Cementless bipolar hemiarthroplasty for displaced fracture neck of femur with modular hydroxyapatite coated stem in elderly with cardiopulmonary co-morbidities

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20171807 ◽

2017 ◽

Vol 5 (5) ◽

pp. 1862

Author(s):

Towseef Ahmad Bhat ◽

Zameer Ali ◽

Amara Gulzar ◽

Furqaan Mirza

Keyword(s):

Femoral Neck ◽

Elderly Patients ◽

Femoral Neck Fractures ◽

Harris Hip Score ◽

Anterolateral Approach ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Cardiopulmonary Complications

Background: Bipolar hemiarthroplasty is one of the common procedures done for fracture neck of femur in elderly. Debate about Cemented or cementless is still on. Cementing increases perioperative mortality by causing significant hemodynamic changes or embolization. Patients with cardiopulmonary complications are at higher risk of cementing complications. We report our series of 31 cases of fracture neck of femur with cardiopulmonary diseases operated over 2 years with modular cementless bipolar hemiarthroplasty.Methods: 31 elderly patients with cardiopulmonary co-morbidities (age=75 to 97 years) with displaced femoral neck fractures were operated between January 2011 to December 2013. Cementless bipolar hemiarthroplasty using hydroxyapatite coated stem was done by single surgeon using same implant in all the patients through anterolateral approach. Clinical and radiological follow-up was done with mean follow up of 54 months (36-72 months).Results: Total 31 cases with cardiopulmonary comorbidities were operated. The average follow up was 54 months. No intraoperative mortality was seen. 3 patients had splitting of femur during canal preparation. 1 patient died due to cardiac arrest in the post-operative period. 1 patient had surgical site infection. 3 patients had hemodynamic abnormalities and 1 patient had significant limb length discripency (1.5 cm). 2 patients died in the follow up because of comorbidities. 27 patients reached to pre-injury status with average harris hip score of 86 at final follow up.Conclusions: Cementless bipolar hemiarthroplasty with hydroxyapatite coated stem is a good option for femoral neck fractures in elderly patients with cardiopulmonary complications without risking the harmful effects of cementing.

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Bicentric Bipolar Prosthesis in Non-Traumatic Hip Pathologies: Maximum 10 Years Follow Up

Birat Journal of Health Sciences ◽

10.3126/bjhs.v2i3.18934 ◽

2018 ◽

Vol 2 (3) ◽

pp. 238-243

Author(s):

Subash Chandra Jha ◽

Anil Kumar Rai ◽

Prakash Shakya

Keyword(s):

Hip Prosthesis ◽

Excellent Result ◽

Harris Hip Score ◽

Neck Of Femur ◽

Secondary Osteoarthritis ◽

Bipolar Prosthesis ◽

Replacement Arthroplasty ◽

Clinical And Radiological Outcome ◽

Modified Harris Hip Score

Introduction: Introduction of bipolar prosthesis was basically made for the treatment of fresh fracture neck of femur in elderly, but with advancement in design and techniques its use has been increased to various non-traumatic hip pathologies.Objective: To assess clinical and radiological outcome of BHU bicentric bipolar hip prosthesis in treatment of non-traumatic hip pathology.Methodology: This longitudinal study was done in 30 cases of various hip conditions, during the period of March 2002 to March 2012. All patients had secondary osteoarthritis of hip with abnormal acetabulum following advanced tubercular arthritis, rheumatoid arthritis, ankylosing spondylitis and avascular necrosis of femoral head. Primary bipolar hemi-replacement arthroplasty was done in all the cases using Banaras Hindu University (BHU) bicentric bipolar hip prosthesis. Each patient was assessed radiologically for movement and fraction of it occurring at various components of prosthesis and clinically for functional outcome using modified Harris hip score for the maximum of 10 years.Results: There were 17 males and 13 females (n=30), aged between 31-60 years. Three and half years following surgery, (n=12) 100% patients were able to squat and sit crossed legged. At four and half years follow-up, (n=7) 100% patient had excellent result when assessed by modified Harris hip score. Radiologically, by the end of 10 years (n=1) all the movements of hip occurred at inner bearing while the outer bearing was fixed to acetabulum.Conclusion: This intermediate term follow-up study suggests that the use of BHU bicentric bipolar hip prosthesis for bipolar hemireplacement is associated with be

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A Convenient Way to do Valgus Osteotomy for Neglected Fracture Neck of Femur

Kathmandu University Medical Journal ◽

10.3126/kumj.v11i2.12491 ◽

2015 ◽

Vol 11 (2) ◽

pp. 147-151

Author(s):

P Bansal ◽

V Singhal ◽

H Lal ◽

D Mittal ◽

RK Arya

Keyword(s):

Young Adults ◽

Successful Outcome ◽

Harris Hip Score ◽

Wedge Osteotomy ◽

Valgus Osteotomy ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Hip Screw ◽

Prospective Longitudinal

Background Neglected fracture of neck of femur in young adults is a major problem in developing countries. Existing treatment options varies from osteotomy to various graft techniques (muscle pedicle, vascularized and nonvascularized fibula etc.). There is paucity of literature regarding the use of double angle barrel plate and hip screw in such cases. We conducted a prospective longitudinal observational study with displaced, neglected fracture neck of femur in young adults and compared the results with literature. Objectives The aim of this study was to determine feasibility and effectiveness of 120° double angle barrel plate and hip screw fixation in neglected fracture neck of femur. Effectiveness of fixed 30 degree closed wedge osteotomy in neglected fracture neck of femur. Methods Thirty cases of neglected (more than three weeks) femoral neck fracture (Pauwel II and III) of age 20-60 years were included in the study conducted at Postgraduate Institute Of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India in year 2004-06. Average age of the patient was 35.4 years (range, 22yrs-55yrs). In all cases internal fixation was done by 120° double angle barrel plate and hip Screw. At the end of follow-up, results were evaluated according to Askin Bryan Criteria and Harris-hip score. Results Union was achieved in 28 of 30 patients. Two patients that went into nonunion were later treated with hemireplacement arthroplasty. According to Askin Bryan Criteria at the end of study, 35% patients had excellent results, 50% patients had good results. Minimum follow-up in our study was 12 months and maximum was five years. Conclusion This study validates the use of double angled screw plate configuration for successful outcome in patients with neglected fracture neck of femur. Valgus osteotomy is also technically easy operation in hands of average trauma surgeon with the use of a fixed angle plate and hip screw.DOI: http://dx.doi.org/10.3126/kumj.v11i2.12491 Kathmandu University Medical Journal Vol.11(2) 2013: 147-151

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Evaluation of functional and clinical outcome of open reduction and internal fixation of Barton’s fracture of the wrist in a central hospital of Kashmir

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20213379 ◽

2021 ◽

Vol 7 (5) ◽

pp. 986

Author(s):

Jawed A. Bhat ◽

Faesal Khurseed ◽

Abdul H. Javaid

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Road Traffic ◽

Excellent Result ◽

Functional Results ◽

Functional Evaluation ◽

College Hospital ◽

Articular Fractures ◽

Limited Range Of Motion

Background: Fractures of the distal end of radius continue to pose a management challenge. Defective alignment of extra articular as well as intra articular fractures result in a variety of complications like post traumatic arthritis, decreased in grip strength and endurance as well as limited range of motion and instability of carpus. The main aim of this study is to assess the functional results of open reduction and internal fixation in the treatment of volar Barton’s fracture.Methods: From December 2006 to December 2019, forty cases of volar Barton’s fracture were operated in Skims Medical College Hospital, Srinagar, Kashmir, however only 32 cases were included in the study group and 8 cases were lost to follow up. In the majority of our cases the injury was sustained as a result of road traffic accident followed by fall. Majority (24) of the cases were operated within one week of trauma, followed by six in two weeks and two in 3 weeks of time since injury.Results: Functional evaluation was done after a mean follow-up of 28.7 months. Fracture union was achieved within 8 to 12 weeks and excellent results were obtained in 18 cases and 10 cases were categorized as good followed by fair result in 4 cases. Median nerve compression was not observed in any case.Conclusions: Good to excellent result can be achieved after open reduction and internal fixation which restores joint congruity.

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Evaluation of functional outcome of displaced fracture neck of femur in elderly treated with cemented bipolar prosthesis by modified Harris hip score

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211610 ◽

2021 ◽

Vol 7 (3) ◽

pp. 561

Author(s):

Shivakumar B. Kerakkanavar ◽

Deepak P. Kaladagi ◽

Nagesh B. Sanakal ◽

Pundaleekappa S. Kaladagi ◽

Praveenkumar A. Hongal

Keyword(s):

Elderly Patients ◽

Functional Outcome ◽

Hip Prosthesis ◽

Limb Lengthening ◽

Harris Hip Score ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Femur Fractures ◽

Modified Harris Hip Score ◽

Displaced Fracture

Background: The current research was conducted to determine the functional outcome of the displaced fracture neck of femur in elderly patients treated with cemented bipolar hip prosthesis.Methods: The present research was a prospective study of 44 cases of displaced fracture neck of femur admitted to our institute between October 2017 and October 2019. Cases were chosen on the basis of inclusion and exclusion criteria. Cases were surgically treated with cemented bipolar hip hemiarthroplasty and functional findings were recorded with modified Harris hip score.Results: In our series of 44 cases there were 30 females and 14 males, with a maximum age of 92 years, minimum age of 65 years, and the average age was 72.72 years. At one-year follow-up, the average modified Harris hip score was 86.75% (maximum score of 95 and a minimum score of 66), overall, 20 patients (45.46%) achieved excellent, 16 patients (36.36%) achieved good, 5 patients (11.36%) achieved fair and 3 patients (6.82%) achieved poor results. 81.82% of the patients returned to the pre-fracture level of activity and independent ambulation. Patients had few complications like limb length discrepancy, 36.3% of patients had limb lengthening between 1 to 1.5 cm.Conclusions: In elderly patients with displaced neck femur fractures, cemented bipolar hip prosthesis provides good functional outcome. However further study for a longer period in a larger sample with a direct comparison between the cemented versus uncemented groups is required.

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Functional outcome of Austin Moore Hemire Placement Arthroplasty in Fracture Neck of Femur in elderly

Journal of Manmohan Memorial Institute of Health Sciences ◽

10.3126/jmmihs.v3i1.19174 ◽

2018 ◽

Vol 3 (1) ◽

pp. 6-15

Author(s):

Tej P. Dawadi ◽

TR Bhatta ◽

B Gyawali ◽

BR Adhikari ◽

SK Giri

Keyword(s):

Weight Bearing ◽

Randomized Study ◽

Functional Results ◽

Harris Hip Score ◽

Full Weight Bearing ◽

Neck Of Femur ◽

Fracture Neck Of Femur ◽

Neck Fracture ◽

Displaced Fracture ◽

Austin Moore

Objective: To study the outcome of Austin Moore Hemireplacement Arthroplasty in terms of Harris Hip Score and Mobility and Aid Score in fracture neck of femur in elderly.Design: A prospective randomized study carried out between September 2011 to August 2012 AD.Methods: We performed 30 Austin Moore hemiarthroplasties in patients aged 65 and above that sustained a displaced femoral neck fracture and evaluated the outcome in terms of Harris Hip Score and Mobility and Aid Score.Results: Mean HHS at 2 week was 63.93 which increased to 73.83, 80.53 and 86.48 at 6 weeks, 12 weeks and 6 months respectively with overall excellent to good result of 60%. The mean MASM at 6 months was 4.0 whereas the pre-injury MASM was 4.53.Conclusion: Hemiarthroplasty with Austin Moore Prosthesis is safe and effective method of treatment for displaced fracture neck of femur in elderly. There was early post-operative full weight bearing mobilization with reduction in major complications. The operative duration, post-operative complicationsare comparable to other similar studies done elsewhere. The end functional results also depend on the associated comorbidities and optimum post op rehabilitation.Journal of Manmohan Memorial Institute of Health SciencesVol. 3, No. 1, 2017, page: 6-15

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Outcomes of Vancouver B2 and B3 periprosthetic femoral fractures after total hip arthroplasty in elderly patients

Hip International ◽

10.1177/1120700018772163 ◽

2018 ◽

Vol 29 (2) ◽

pp. 184-190 ◽

Cited By ~ 9

Author(s):

Jesús Moreta ◽

Iker Uriarte ◽

Amaia Ormaza ◽

Javier Mosquera ◽

Kattalin Iza ◽

...

Keyword(s):

Elderly Patients ◽

Fracture Healing ◽

Femoral Fractures ◽

Functional Results ◽

High Rate ◽

Periprosthetic Fractures ◽

Harris Hip Score ◽

Periprosthetic Femoral Fractures ◽

The Mean

Introduction: The objective was to evaluate clinical and radiological outcomes of Vancouver B2 and B3 periprosthetic femoral fractures in patients older than 65 years treated at our institution from 2000 to 2014. We compared the most common methods of fixation: a modular tapered rectangular titanium stem versus a monoblock tapered stem. Methods: A retrospective review was performed with a minimum follow-up time of 2 years. Patient mobility in the period prior to the fracture and after fracture healing and functional results was assessed according to the Harris Hip Score. Results: A total of 43 Vancouver B2 and B3 periprosthetic fractures fulfilled the inclusion criteria (31 type B2 and 13 type B3). The mean age was 78 years old (66–88 years). The mean follow-up time was 5 years (range 2–12 years). A Wagner stem was used in 19 patients and a modular rectangular stem was implanted in 24 patients. Although fracture union was achieved in 93% of the cases, the mean Harris Hip Score was 73 (34–87) and 41.9% of the patients did not return to their previous ambulatory levels ( p = 0.0049). Dislocation was the most common complication (16.3%). We have found association ( p = 0.07) between subsidence with a mean of 4.14 mm and dislocation. No difference was observed between B2 and B3 fractures or between modular and monoblock stems. Discussion: Although we reported good results of fracture healing, there were functional impairment and a high rate of complications, especially dislocation, in Vancouver B2 and B3 periprosthetic fractures in elderly patients.

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Porous tantalum acetabular cups for reconstructions after peri-acetabular resections of primary bone tumours

Hip International ◽

10.1177/11207000211001552 ◽

2021 ◽

pp. 112070002110015

Author(s):

Riccardo Zucchini ◽

Andrea Sambri ◽

Claudio Giannini ◽

Michele Fiore ◽

Carlotta Calamelli ◽

...

Keyword(s):

Bone Tumour ◽

Hip Dislocation ◽

Functional Results ◽

Bone Tumours ◽

Harris Hip Score ◽

Porous Tantalum ◽

Term Survival ◽

Primary Bone ◽

Primary Bone Tumours

Introduction: Periacetabular reconstruction after resection of primary bone tumour is a very demanding procedure. They are frequently associated with scarce functional results and a high rate of complications. We report a series of patients with periacetabular resections for primary bone tumours and reconstruction with a porous tantalum (PT) acetabular cup (AC). Materials and methods: 27 patients (median age 30 years) were included, being affected by primary bone tumours of the pelvis and treated with peri-acetabular resection and reconstruction with a PT AC. The diagnoses were 13 osteosarcomas, 7 chondrosarcomas and 7 Ewing sarcomas. Function was assessed with the Harris Hip Score and complications were classified according to Zeifang. Results: The median follow-up was 70 months. 1 patient required removal of the PT AC because of implant associated infection 55 months after surgery. There was 1 hip dislocation and no case of aseptic loosening. At final follow-up, the median HHS was 81 points (range 48–92). Conclusions: The used PT AC had good medium-term survival rates and good functional results. This technique is a viable reconstructive option after resections of periacetabular primary bone sarcomas.

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AUSTIN MOORE PROSTHESIS IN THE MANAGEMENT OF FRACTURE NECK OF FEMUR IN AN ELDERLY POPULATION.

10.36106/ijsr/3825631 ◽

2020 ◽

pp. 73-75

Author(s):

Ravi Kumar ◽

Chandan Kumar

Keyword(s):

Functional Outcome ◽

Treatment Option ◽

Elderly Population ◽

Tertiary Care ◽

Walking Distance ◽

Neck Of Femur ◽

Protrusio Acetabuli ◽

Fracture Neck Of Femur ◽

Austin Moore

Introduction: Intracapsular fractures of the proximal femur form a major share of fractures in the 77 elderly. Hip replacement arthroplasty (partial or total) is emerging as a most viable treatment option, and in that, hemiarthroplasty with the Austin Moore Prosthesis is among the most commonly employed. In our study, we have made an attempt to assess the functional status at long term follow up after hemiarthroplasty with the AMP, used in the treatment of fracture neck of femur in the elderly population, and to substantiate the use of the prosthesis in modern day orthopaedic practice. Materials and : A retrospective study was carried out in patients above the age of 60 years, who had been diagnosed with non-pathological fracture neck of femur, treated operatively with hemiarthroplasty using the Austin Moore prosthesis in a tertiary care centre. A minimum follow up period of two years was considered. All the patients were evaluated clinically, and wherever possible, radiologically. Functional outcome was assessed based on the Harris Hip scoring system, and the results were analysed. Radiologically, an attempt was made to assess, among others, the amount of protrusio acetabuli at follow up, and femoral offset changes following hemiarthroplasty with the AMP. Results: In our study, we observed a positive functional outcome (excellent or good) in 9(45%) patients, with fair result in 6(30%) and poor in 5(25%). However, when pain alone was taken as criteria for assessment, upto 14(75%) patients had none to slight pain at follow up, and only 1(5%) patient had marked pain. Walking distance was significantly reduced in 6(30%) patients, who were either confined indoors or bedridden, but in only 1(5%) of them, the cause for the decreased ambulatory status was implant or procedure related (pain). Among the complications, 1 patient had a post-operative periprosthetic fracture that healed subsequently, 2 patients had marked osteolysis around the stem of the prosthesis, and only 1 patient had a radiological evidence of protrusio acetabuli. Discussion: Hemiarthroplasty with Austin Moore Prosthesis for fracture neck of femur remains a fairly good treatment option in elderly patients.

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Functional Outcome of Intracapsular Femoral Neck Fractures Treated by Bipolar Hemiarthroplasty

10.53350/pjmhs21155988 ◽

2021 ◽

Vol 15 (5) ◽

pp. 988-991

Author(s):

Zamir Hussain Tunioi ◽

Rizwan Ali Jhatiyal ◽

M Azeem Akhund ◽

M Kashif Abbasi ◽

L Das Maheshwari ◽

...

Keyword(s):

Femoral Neck ◽

Functional Outcome ◽

Femoral Neck Fractures ◽

University Hospital ◽

Harris Hip Score ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Cross Sectional ◽

Average Hospital

Aim: To evaluate the functional outcome of bipolar hemiarthroplasty in intracapsular fracture neck of femur. Study design: Descriptive cross sectional study. Place and duration of study: Department of Orthopaedic Surgery & Traumatology, Peoples Medical University Hospital, Shaheed Benazir Abad from 1st December 2017 to 31st December 2020. Methodology: Sixty six cases of intracapsular femoral neck fractures with age ranging from 50 year to 75 year of either gender who were ambulatory before injury were included; while basicervical, younger than 50 years, with neuromuscular disorder, unfit for surgery, open fracture, bilateral injuries, osteoarthritis of hip, Rheumatoid, Gouty, pathological fractures, bedridden & who did not give consent for study, were excluded from the study. Functional outcome assessed by Harris hip score & data analyzed by SPSS version 23. Results: Twenty six (59.09%) were male and 40 (40.91%) were female with mean age of 64.3±7.77 year. Average time from injury to hospital arrival was 14.7±6.8 hours. Average time from hospitalization to surgery was 4.67±2.23 days. Average time of surgery was 55.67±9.9 minutes. Average hospital stay was 9.7±4.3 days. The average time of follow-up was 18.45±7.63 months. Conclusion: Bipolar implant is safe, effective, reliable, stable and cost effective implant for intracpsular fracture of femoral neck in elderly populace. The 66.66% of patients have satisfactory Harris hip score in follow up duration of 18.45±7.63 months. Keywords: Functional, Outcome, Femoral neck fractures, FNF, Bipolar, Hemiarthroplasty, HHS

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