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

Background: 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.Methods: 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. Results: 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.Conclusions: 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 & complications, were both less in the uncemented group as compared to cemented hemiarthroplasty group in our study.

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Acetabular erosion after hemiarthroplasty

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20175140 ◽

2017 ◽

Vol 4 (1) ◽

pp. 53

Author(s):

Venkatesh Kumar N. ◽

Arvind Kumar S. M. ◽

Vinayagamoorthy . ◽

Sairamakrishnan S.

Keyword(s):

Functional Activity ◽

Activity Level ◽

Clinical Activity ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Femur Fractures ◽

Ucla Score ◽

Cemented Bipolar Hemiarthroplasty ◽

Neck Of Femur Fracture ◽

Acetabular Erosion

Background: Neck of femur fractures are one of the devastating injuries in the old age. Their incidence is on the rise causing immense stress on the society. One of the most commonly done procedure is bipolar hemiarthroplasty. In our study we have evaluated the acetabular erosion after hemiarthroplasty, in neck of femur fracture patients after a minimum period of 2 years and have tried to correlate it with activity level of the patient.The aim of the study were early detection of acetabular erosion; to assess the functional outcome after minimum of 2 years after hemiarthroplasty by modified UCLA score; to correlate the functional activity level and radiological acetabular erosion.Methods: This is a retrospective radiological and clinical study. The post hemiarthroplasty plain radiographs, showing AP view of hip joint taken in the Department of Radiodiagnosis, PSGIMS&R will be studied along with activity level assessment. By Convenient sampling method, all the patients undergone cemented bipolar hemiarthroplasty, for fracture neck of femur after minimum of 2 years were assessed both radiologically and clinically. Functional activity level was assessed by Modified UCLA scoring system.Results: By this study we suggest an easy and effective way of evaluating acetabular erosion and clinical activity. There is significant increase in acetabular erosion as the duration after surgery increases. Conclusions: By this study we suggest an easy and effective way of evaluating acetabular erosion and clinical activity. There is significant increase in acetabular erosion as the duration after surgery increases. The clinical activity is by and large not significantly altered as the erosion progress at mid-term follow up.

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Cemented versus Uncemented Hemiarthroplasty for Femoral Neck Fractures in Patients with Neuromuscular Diseases: A Minimum of 2 Years Follow-Up Study

10.21203/rs.3.rs-510142/v1 ◽

2021 ◽

Author(s):

Yuchuan Wang ◽

Zhongzheng Wang ◽

Siyu Tian ◽

Zhanchao Tan ◽

Yanbin Zhu ◽

...

Keyword(s):

Femoral Neck ◽

Neuromuscular Diseases ◽

Femoral Neck Fractures ◽

Intraoperative Blood Loss ◽

Uncemented Hemiarthroplasty ◽

Duration Of Surgery ◽

The Mean ◽

Uncemented Group

Abstract Background The aim of this study is to compare the outcomes of cemented and uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular disease. Methods We reviewed 156 patients with neuromuscular disease who underwent hemiarthroplasty between 2015 and 2019. Patients were divided into cemented group (n = 105) and uncemented group (n = 51), with a minimum follow-up of 2 years. Factors including preoperative features, duration of surgery, intraoperative blood loss, complications, pain, Harris hip scores (HHS), and quality of life were compared across groups, and Kaplan-Meier curves were used to estimate survival. Results In the uncemented group, the mean duration of surgery was 16.0 minutes shorter (p = 0.001) and the mean intraoperative blood loss was 71.1 mL less (p = 0.01). Visual analog scales (VAS), HHS and European Quality of Life-5 Dimensions (EQ-5D) scores were not different between the groups. Despite a few potential trends, we did not observe a difference in complications such as periprosthetic fractures and dislocations. The rates of mortality were similar between groups (p=0.821). Conclusions Both arthroplasties may be used with good medium-term results in the treatment of femoral neck fractures in patients with neuromuscular diseases.

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Post-operative mortality and factors related to mortality after bipolar hemiarthroplasty in patients with femoral neck fractures

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4520 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2604-2608

Author(s):

Prabhakaran A ◽

Selvakumar P ◽

Krishnagopal R ◽

Anisha Rao

Keyword(s):

Hip Fractures ◽

Small Sample Size ◽

The Elderly ◽

Small Sample ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Medical College ◽

Femur Fractures ◽

Gandhi Medical College ◽

Surgical Duration

Hip fractures are a common entity in the elderly. Hemiarthroplasty is a common treatment option for displaced neck of femur fractures and have been found to be successful in restoring mobility, reducing pain and improving quality of life following hip fractures in elderly. Many studies have reported that advanced age, male gender, long term stay in the intensive care unit, poor postoperative mobilization ability, a poor or dependent ADL score preoperatively, multiple comorbidities which result in a high ASA score have been associated with higher mortality. A retrospective study was done at the Department of Orthopaedics at Mahatma Gandhi Medical College and Research Institute, Pondicherry which included all patients who underwent hemiarthroplasty (both cemented and uncemented) from 2017-2020. The details of patients satisfying the inclusion criteria were obtained from the medical records department and were analysed by a single investigator. In case the subjects had not reviewed following surgeries, details were obtained by telephonic communication. In our study of 40 patients, mortality was observed in 4 patients which included 3 females and 1 male. It was also observed that mortality was high between the ages of 61-80 years, patients with multiple comorbidities and patients with high ASA scores. The hazard ratio was calculated for 3 parameters namely age, time to surgery and surgical duration and is 1.014, 0.842 and 0.984 respectively but this was not found to be statistically significant. This may due to the small sample size and retrospective nature of our study.

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Displaced intracapsular neck of femur fractures in the elderly: Bipolar hemiarthroplasty may be the treatment of choice; a case control study

Injury ◽

10.1016/j.injury.2015.06.047 ◽

2015 ◽

Vol 46 (10) ◽

pp. 1988-1991 ◽

Cited By ~ 15

Author(s):

S.C. Jonas ◽

R. Shah ◽

N. Al-Hadithy ◽

M.R. Norton ◽

S.A. Sexton ◽

...

Keyword(s):

Case Control Study ◽

The Elderly ◽

Case Control ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Femur Fractures ◽

Control Study

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

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/22104917211022026 ◽

2021 ◽

Vol 28 ◽

pp. 221049172110220

Author(s):

Toh Ruixiang ◽

Padki Akshay ◽

Yew Andy ◽

Yeo H Shan ◽

Koh Joyce ◽

...

Keyword(s):

Quality Of Life ◽

Hip Fractures ◽

Retrospective Review ◽

Hip Prosthesis ◽

Bipolar Hemiarthroplasty ◽

Neck Of Femur ◽

Femur Fractures ◽

Significant Difference ◽

Uncemented Hemiarthroplasty

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.

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Cemented versus uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular diseases: a minimum of 2 years’ follow-up study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02572-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yuchuan Wang ◽

Zhongzheng Wang ◽

Siyu Tian ◽

Zhanchao Tan ◽

Yanbin Zhu ◽

...

Keyword(s):

Femoral Neck ◽

Neuromuscular Diseases ◽

Femoral Neck Fractures ◽

Intraoperative Blood Loss ◽

Uncemented Hemiarthroplasty ◽

Duration Of Surgery ◽

The Mean ◽

Uncemented Group

Abstract Background The aim of this study was to compare the outcomes of cemented and uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular disease. Methods We reviewed 156 patients with neuromuscular disease who underwent hemiarthroplasty between June 2015 and December 2019. Patients were divided into cemented group (n = 105) and uncemented group (n = 51), with a minimum follow-up of 2 years. Factors including preoperative features, duration of surgery, intraoperative blood loss, complications, pain, Harris hip scores (HHS), and quality of life were compared across groups, and Kaplan–Meier curves were used to estimate survival. Results In the uncemented group, the mean duration of surgery was 16.0 min. shorter (p = 0.001) and the mean intraoperative blood loss was 71.1 mL less (p = 0.01). Visual analog scales (VAS), HHS, and European Quality of Life-5 Dimensions (EQ-5D) scores were not different between the groups. Despite a few potential trends, we did not observe a difference in complications such as periprosthetic fractures and dislocations. The rates of mortality were similar between groups (p=0.821). Conclusions Both arthroplasties may be used with good medium-term results in the treatment of femoral neck fractures in patients with neuromuscular diseases.

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P16 An audit of elderly patients with a femoral fracture: is the quality of care received by patients affected by where in the femur the fracture occurs?

BJS Open ◽

10.1093/bjsopen/zrab032.015 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

O A Javed ◽

M J Khan ◽

Y Abbas ◽

S Pillai ◽

K Hristova ◽

...

Keyword(s):

Risk Assessment ◽

Elderly Patients ◽

Bone Health ◽

Nutritional Assessment ◽

Femur Fracture ◽

Femoral Fractures ◽

Neck Of Femur ◽

Femur Fractures ◽

Neck Of Femur Fracture ◽

Health Review

Abstract Introduction Elderly patients with femoral fractures are often frail and require a multidisciplinary approach to optimise medical care, rehabilitation and prevention of further injury. Previously, neck of femur fracture patients were the focus of such an approach, but NICE and BOAST guidelines emphasise extending this care to other elderly trauma patients. Methods A retrospective analysis of 43 patients over 60 years old at Gloucestershire Hospitals NHS Foundation Trust in 2019 with a femoral fracture other than a neck of femur fracture. BOAST guideline standards were surgery within 36 hours, orthogeriatric assessment within 72 hours, a documented ceiling of treatment, falls risk assessment, bone health review, nutritional assessment and physiotherapy review. Results Our study showed worse outcomes in all standards for patients with femoral shaft, distal femur and periprosthetic femur fractures compared to neck of femur fractures: surgery within 36 hours (63.9% vs. 66%); orthogeriatric assessment within 72 hours (32.6% vs. 91.9%); falls risk assessment (76.7% vs. 99.6%); bone health review (41.9% vs. 99.7%); nutritional assessment (55.8% vs. 99.6%); physiotherapy review (97.7% vs. 98.9%). The group also had worse outcomes for average length of stay (19 days vs. 14 days) and 30 day mortality (9.3% vs. 8.6%). Discussion Our study showed a discrepancy in care received by elderly patients with femoral fractures other than neck of femur. We will introduce a proforma for all femoral fractures, present our findings to orthogeriatric, bone health and physiotherapy teams to involve them in the care of such patients and re-audit following these recommendations.

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

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2021.v7.i2f.2664 ◽

2021 ◽

Vol 7 (2) ◽

pp. 455-460

Author(s):

Dr. Akshay Nayak ◽

Dr. Arvind B Goregaonkar ◽

Dr. Vishal Raina ◽

Dr. Nirav R Gupta ◽

Dr. Shreenidhi K Kulkarni

Keyword(s):

Elderly Patients ◽

Prospective Study ◽

Functional Outcome ◽

Bipolar Hemiarthroplasty ◽

Short Term ◽

Neck Of Femur ◽

Femur Fractures

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Assessment of the outcome of fracture intertrochanteric femur treated by trochanteric fixation nail in the elderly population

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20205573 ◽

2020 ◽

Vol 7 (1) ◽

pp. 125

Author(s):

Vipin Tyagi ◽

Rahul Kakran ◽

Amit Dwivedi ◽

Fenil Shah

Keyword(s):

Elderly Population ◽

The Elderly ◽

Early Rehabilitation ◽

Harris Hip Score ◽

High Morbidity ◽

Intertrochanteric Fractures ◽

Early Weight Bearing ◽

Duration Of Surgery ◽

The Mean ◽

Trochanteric Fixation Nail

Background: Intertrochanteric fractures femur in elderly population are more commonly forbidden high morbidity. The surgical stabilization together with early rehabilitation is the main challenge. The elderly population have poor bone mass quality and also the chances of complications like nonunion or implant failure are more with conventional procedures. Stable fixation and early rehabilitation is the main aim in intertrochanteric fractures. The aim is to assess the functional outcome of intertrochanteric fractures femur managed by trochanteric fixation nail (TFN) in the elderly population.Methods: The study includes 40 patients, 30 male and 10 female, with fracture intertrochanteric femur treated with TFN from September 2018 to May 2019 at Yashoda Superspeciality Hospital, Nehrunagar, Ghaziabad. The patients were evaluated at 4, 8, 12 weeks postoperatively and assessed by the Modified Harris hip score. Classification used is AO classification.Results: The mean age of patients was 64 years. The mean duration of surgery was 48±10 min. The Harris hip score was 96.90±4.60, which is better than scores from other implants used for intertrochanteric fractures femur.Conclusions: In this study, we conclude that TFN is a good choice in managing the intertrochanteric fractures, having higher bone union rate and less union time. The period of immobilization is decreased, early weight bearing and less complications.

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Bilateral pathological neck of femur fractures associated with low grade splenic marginal zone lymphoma: Case report, and review of the literature

International Journal of Diagnostic Imaging ◽

10.5430/ijdi.v1n2p47 ◽

2014 ◽

Vol 1 (2) ◽

pp. 47

Author(s):

F Fallahi ◽

A Waton ◽

M Mansha ◽

W Cope ◽

H O’Brien ◽

...

Keyword(s):

Marginal Zone ◽

Marginal Zone Lymphoma ◽

Low Grade ◽

Splenic Marginal Zone Lymphoma ◽

Pathological Fractures ◽

Neck Of Femur ◽

Femur Fractures ◽

Clinical Literature ◽

Current Guidance ◽

Neck Of Femur Fracture

We report a case involving a 64 year old lady with bilateral pathological fractures of the neck of the femur secondary to Low Grade Splenic Marginal Zone Lymphoma, a pathology that has not previously been described in clinical literature. This particular case also highlights the value of the diagnosis and management of patients presenting with subtle and unusual symptoms, and supports the current guidance of the National Institute for Health and Care Excellence regarding the investigation of patients with suspected pathological neck of femur fracture.

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