Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in octogenarians

“…There were 19 studies that used cemented stem, 14 that used cementless stem, and two comparative studies that used both stems. Eleven studies were prospective studies, which used methods with wires, cables, and sutures for fixation of fracture fragments 1 2 4 11 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42) .…”

Section: Resultsmentioning

confidence: 99%

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

et al. 2018

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PurposeThis study was conducted to compare cemented and cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures via meta-analysis and systematic review of relevant studies.Materials and MethodsSystematic review and meta-analysis were performed on 31 available clinical studies; 19 of these studies used cemented stems, 12 used cementless stems, one used both types of stems, and two studies involved a comparative analysis of both stem types.ResultsThere were statistically significant differences in rates of leg length discrepancy (LLD) greater than 1 cm between the cemented (event rate, 0.089) and cementless groups (event rate, 0.015 and 0.047; P=0.03).ConclusionCemented bipolar hemiarthroplasty and cementless bipolar hemiarthroplasty performed on elderly patients with unstable intertrochanteric fracture revealed similar mortality and complication rates; however, the rate of LLD greater than 1 cm was significantly higher in the cemented group compared with the cementless group.

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“…In the hemiarthroplasty technique the prosthesis metaphyseal fit should be obtained by reconstructing the comminuted calcar and the greater trochanter or by the bone cement mantle if the distorted comminuted fragments cannot be restored. Kim y et al reported that comminuted posteromedial fragments should be stably fixed to avoid stem subsidence [23] . This complex surgical technique prolongs the surgery time and increases the blood loss and infection rate.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of treatment of unstable intertrochanteric fractures with PFN and cemented hemiarthroplasty

Rajarajan¹

2018

Int. J. Orthop. Sci.

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Aim: Aim of the study is to analyse and compare the functional outcomes and radiological results of two different surgical modalities, PFN and cemented hemiarthroplasty in the treatment of unstable intertrochanteric fractures in elderly patients. Background: Elderly patients with intertrochanteric fractures should be mobilized early to reduce the morbidity and mortality. While cemented hemiarthroplasty allows early weight bearing, the prolonged surgical time increase the blood loss and mortality, whereas with PFN once the fracture becomes stable allows early mobilization thus overcoming the problems of recumbency. PFN efficiently preserves the femoral head and the abductor mechanism and thus has the biomechanical advantage of increased range of hip joint movements and better functional outcome. Materials and methods: Sixty patients of age 60 years and above with comminuted intertrochanteric fractures treated by PFN or cemented hemiarthroplasty were taken up for the prospective study in our institute between january2013 and june 2015. 30 patients underwent PFN and 30 patients had hemiarthroplasty. Average period of follow up was 2 years. Post-operative complications and mortality rates were compared between the two groups. Functional results and the hip range of movements were assessed by Harris Hip Score (HHS). In the mean follow up period of 22months radiological examination was done to assess the results & complications. Results:The demographic and background data of the patients in the two groups are statistically similar. At 2 years follow up PFN group patients had a mean HHS of 85.89 and HA group had 78.11. Pain, severity and range of hip movements are better in PFN group than HA group. Radiologicaly 4 patients in HA group had stem loosening and 2 patients had screw cut out in the PFN group with subsequent pain in the final follow up. Conclusion: PFN is a better option for the treatment of elderly intertrochanteric fractures as the operative time is short, easier surgical procedure & has less mortality. PFN also gives a better functional outcome in the late follow up than hemiarthoplasty.

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Cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in octogenarians

Abstract: Cementless bipolar hemiarthroplasty appears to be a suitable method for the treatment of intertrochanteric fracture in octogenarians. However, stable fixation of the posteromedial fragment is necessary to avoid stem subsidence.

Cited by 16 publications

References 24 publications

Bipolar Hemiarthroplasty for Unstable Intertrochanteric Femur Fracture in Patients over the Age of 80 Years: Comparative Analysis between Cementless and Cemented Stem

Bipolar Hemiarthroplasty for Unstable Intertrochanteric Femur Fracture in Patients over the Age of 80 Years: Comparative Analysis between Cementless and Cemented Stem

Comparison between Cementless and Cemented Bipolar Hemiarthroplasty for Treatment of Unstable Intertrochanteric Fractures: Systematic Review and Meta-analysis

A comparative study of treatment of unstable intertrochanteric fractures with PFN and cemented hemiarthroplasty

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