NON CEMENTED BIPOLAR HEMI-ARTHROPLASTY, SURGICALLY INTERVENED FOR GERIATRIC FRACTURES OF NECK OF FEMUR, THAT ARE DISPLACED: A PROSPECTIVE CASE SERIES STUDY.

2021 ◽  
pp. 73-76
Author(s):  
Arun Kumar.C ◽  
Arun Kumar KV ◽  
Ashwanth Narayan B ◽  
Venkatachalam K ◽  
Saran Karthik S ◽  
...  
Keyword(s):  
Prospective Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
The Elderly ◽  
Transfusion Rate ◽  
Complication Rates ◽  
Neck Of Femur ◽  
Total Hip ◽  
Hemi Arthroplasty

Fracture neck of femur which are displaced, do not nd a place in the elderly where the head can be preserved even if there is a surgical intervention. Fixation devices like the DHS have time and again failed to satisfactorily treat these fractures. It's here that the Bipolar Hemi Arthroplasty comes to us, as a very handy operative tool. The question is, whether or not the stem of the Bipolar, be cemented or not. The problems of cementation in the elderly carries the risk of BCIs – the bone cementing implantation Syndrome; which can at times be fatal. Cementation makes, future needed Total Hip Replacement, more difcult. In this prospective study of patients conducted at Chettinad Hospital and Research Institute, Kelambakkam, South India ; we have chosen an age group between 61 to 75 years, with an inclusion criterion satisfying type III or IV Garden, but also at the same time, be classiable, as a type A or type B DORR's classication. Our male to female ratio was 1:2 the mean age was 68.5 years and 93.3% (n=84) of patients undergoing un-cemented Hemi-Arthroplasty, when graded by HHS were either Excellent or Good. We had no Poor outcomes in our study. Our minimum follow up was for 12 months, with a mean follow up of 23.5 months. All our cases were done by the Southern Moore's approach, with an average duration of surgery at 82 minutes. The blood loss on an average was 285 ml and the average blood transfusion rate was at 1.8 units. The average post operative stay was for 12 days. From this short-term prospective study, we concluded that Un-Cemented Hemi-replacement Arthroplasty gives Good to Excellent clinico-functional outcomes. It also does not cause any hindrance, if future Total Hip Replacement, is required. Our complication rates were also manageable, with only about 6.7% (n=6) patients, needing revision surgery due to stem loosening.

scholarly journals Uncemented versus cemented arthroplasty after metal-on-metal total hip replacement in patients with femoral neck fractures: a retrospective study

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Wenlu Liu ◽  
Huanyi Lin ◽  
Xianshang Zeng ◽  
Meiji Chen ◽  
Weiwei Tang ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Clinical Outcomes ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Total Hip ◽  
Metal On Metal

Objective To compare the clinical outcomes of primary metal-on-metal total hip replacement (MoM-TR) converted to uncemented total hip replacement (UTR) or cemented total hip replacement (CTR) in patients with femoral neck fractures (AO/OTA: 31B/C). Methods Patient data of 234 UTR or CTR revisions after primary MoM-TR failure from March 2007 to January 2018 were retrospectively identified. Clinical outcomes, including the Harris hip score (HHS) and key orthopaedic complications, were collected at 3, 6, and 12 months following conversion and every 12 months thereafter. Results The mean follow-up was 84.12 (67–100) months for UTR and 84.23 (66–101) months for CTR. At the last follow-up, the HHS was better in the CTR- than UTR-treated patients. Noteworthy dissimilarities were correspondingly detected in the key orthopaedic complication rates (16.1% for CTR vs. 47.4% for UTR). Statistically significant differences in specific orthopaedic complications were also detected in the re-revision rate (10.3% for UTR vs. 2.5% for CTR), prosthesis loosening rate (16.3% for UTR vs. 5.9% for CTR), and periprosthetic fracture rate (12.0% for UTR vs. 4.2% for CTR). Conclusion In the setting of revision of failed primary MoM-TR, CTR may demonstrate advantages over UTR in improving functional outcomes and reducing key orthopaedic complications.

SHALL IT BE BETTER, AS AN APPROACH FOR THR, POSTERIORLY OR LATERALLY; A CLINICO-FUNCTIONAL AND GAIT ANALYTICAL OUTCOME ANALYSIS, IN A PROSPECTIVE STUDY, IN THE SOUTH-INDIAN POPULATION.

2021 ◽  
pp. 71-75
Author(s):  
Arun Kumar C ◽  
Ganashree S ◽  
Arivoli S ◽  
Aswath C A ◽  
Rakesh Kumar B ◽  
...  
Keyword(s):  
Prospective Study ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Posterior Approach ◽  
Lateral Approach ◽  
Harris Hip Score ◽  
South Indian Population ◽  
Total Hip ◽  
South Indian

Introduction: Hip resurfacing arthroplasty (HRA) or Total hip replacement (THR), as it is popularly called, attempts to mollify these basic clinical problems, in patients with a hip arthritic problem, which may be of a sequela to age-related degeneration, osteonecrosis, systemic disorder like Rheumatoid arthritis (RA) or Ankylosing spondylosis (AS) or as a result of trauma and or an old infection. The basic pathology, is an unfavourable and abrading hip diarthrodial joint. The endeavour of the study was, to establish the efcacy of the Posterior vs Lateral approach for THA/THR, by studying their outcomes in primary THR. This prospective study was undertaken at Che Materials And Methods: ttinad Hospital and Research Institute (CARE), Kelambakkam, Chengalpattu district, Tamilnadu, In the Department of Orthopaedics from Jan 2017 to Dec 2020 (48 months). The Functional outcome of hip surgery was measured using the Harris Hip Score, Oxford hip score and the WOMAC. Rivermead visual gait analysis (RVGA) method was used post-operatively to assess the gait. The Biomechanical outcomes of Abductor Gait Component, were individually assessed by EMG studies. The Harris Hip Score, The Oxford Hip S Results: core and WOMAC score, when the lateral approach was compared to the posterior approach pre-op and post-op in the 12 months minimum follow-up period, the laterally approached group faired better. The VAS score was equivocal. The comprehensive RVGA assessment also showed marginally better results for the laterally approached group as was the case with the Trendelenburg test score. The EMG studies for the Gluteus Maximus, Medius and the lateral rotators of hip also favoured the outcomes for the laterally approach hips. The supremacy of the Lateral Approach, ove Conclusion: r Posterior Approach, cannot be adjudged in a short-term follow-up study. It is thus opined that the Lateral Approach may be statistically and data wise superior, but the patient satisfaction, which is a major factor, is almost the same in both the approach groups. The follow-up needs to be atleast for a decade for us to be able to come to any meaningful conclusion. With regards to surgery like the Total hip replacement, which have a longevity factor exceeding 10 years, studies have to be followed up for periods in excess of 10 years.

Short-Term Clinical Assessment of Hip Hemi-Arthroplasty in 11 Dogs

2021 ◽  
Author(s):  
Renée Huggard ◽  
Grace Wicks ◽  
Gordon Corfield
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Salvage Procedure ◽  
Short Term ◽  
Total Hip ◽  
Pelvic Radiography ◽  
Hemi Arthroplasty

Abstract Objective The aim of this study was to assess the short-term clinical outcome in dogs following a hip hemi-arthroplasty for the treatment of primary pathological disorders of the hip and as a salvage procedure following failure of the cup component of a total hip replacement. Materials and Methods Medical records of dogs that had a unilateral hip hemi-arthroplasty performed between 2015 and 2020 were reviewed. Data collected included follow-up orthopaedic examinations performed at 0, 2, 8 and 52 weeks postoperatively, pelvic radiography at 0, 8 and 52 weeks postoperatively and an owner questionnaire (Helsinki chronic pain index [HCPI]). Results Eleven unilateral hip hemi-arthroplasty procedures were identified. The median age at time of surgery was 3.6 years (8 months–10 years) and the median follow-up time was 13 months (range: 2 months–3 years). The HCPI for all dogs at follow-up was median 8 ± 7.30 (range: 5–25). Total HCPI was < 12 for 7/10 dogs and ≥ 12 for 3 dogs. Pelvic radiographs at 1 year confirmed osteointergration of the femoral stem implant and no evidence of implant subsidence or progression of osteoarthritis. However, there was some evidence of mild lucency of the acetabular bed around the prosthetic femoral head and mild peri-acetabular sclerosis in four cases. Conclusion Hip hemi-arthroplasty provides a clinically acceptable treatment for disabling disease of the coxofemoral joint with 10/11 patients achieving acceptable short-term clinical function. Long-term assessment of the hip hemi-arthroplasty and comparison with total hip replacement is indicated.

scholarly journals A three year prospective study of functional and clinical outcomes of total hip replacement at a tertiary care hospital

2020 ◽  
Vol 6 (2) ◽  
pp. 308
Author(s):  
Addanki Vijayanand ◽  
Narreddy Jayasomeswar
Keyword(s):  
Prospective Study ◽  
Total Hip Replacement ◽  
Hip Joint ◽  
Hip Replacement ◽  
Tertiary Care ◽  
The Body ◽  
Laboratory Evaluation ◽  
Care Hospital ◽  
Total Hip

<p class="abstract"><strong>Background:</strong> Hip joint is a crucial joint in the body whose function is essential for normal daily activities. Osteoarthritis of the hip cripples the daily functional capacity and total hip arthroplasty is considered to relieve the pain and increase the quality of life among these patients. The objective of present study was to assess the clinical and functional outcome in total hip replacement patients in terms of early joint function and stability of the hip joint and also to assess complications of procedures.</p><p class="abstract"><strong>Methods:</strong> A three-year prospective study was conducted on 58 cases that fulfilled the inclusion criteria. Ethical approval and consent were obtained for the study. Standard clinical and laboratory evaluation was performed on all the cases and the data was noted in Microsoft excel sheet and analyzed. Modified Harris hip scoring was done pre operatively and postoperatively and follow-up was done at discharge, 4<sup>th</sup> week, 6 months and one year.<strong></strong></p><p class="abstract"><strong>Results:</strong> Surgery was performed on 58 cases with age range 34-73 years and a mean of 43.58 years. Avascular necrosis was the main indication (55.2%). Maximum patient follow-up was 38 weeks. The mean preoperative score was 41.04 with minimum score being 10 and maximum being 76, postoperative score was 99.63 with minimum 64 and maximum was 109. Statistical significance was observed between preoperative and postoperative scores with regard to the parameters of pain, gait, functional activity and range of motion. Anterior thigh pain was the common postoperative complaint (15.5%).</p><p class="abstract"><strong>Conclusions:</strong> In conclusion, total hip replacement gives good clinical and functional outcomes. However, the outcomes are influenced by multiple factors which include indication for surgery, age of the cases, and type of prosthesis, operative technique and post-operative follow up.</p><p class="abstract"> </p>

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