Femoral head measurement in hemiarthroplasty: assessment of interobserver error using 3 measuring systems

Jeffery, J.A.; Ong, Tun-Chen

doi:10.1016/s0020-1383(99)00242-9

Cited by 13 publications

(8 citation statements)

References 4 publications

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“…Both head options were available in 1 mm size increments. The diameter of the femoral head was measured using full circular measurement templates during surgery (Jeffery and Ong 2000 ), and the corresponding prosthetic head size was chosen ( Table 1 ). Arthroplasty was performed through a posterior approach with the patient in the lateral decubitus position, using spinal anesthesia.…”

Section: Interventionmentioning

confidence: 99%

Higher cartilage wear in unipolar than bipolar hemiarthroplasties of the hip at 2 years: A randomized controlled radiostereometric study in 19 fit elderly patients with femoral neck fractures

et al. 2018

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Background and purpose — The use of unipolar hemiarthroplasties for femoral neck fractures is increasing in some countries due to reports of higher reoperation rates in bipolar prostheses. On the other hand, it has been proposed that bipolar hemiarthroplasties have clinical advantages and less cartilage wear than unipolar hemiarthroplasties. We compared cartilage wear between bipolar and unipolar hemiarthroplasties using radiostereometric analyses (RSA), in patients aged 70 years or older.Patients and methods — 28 ambulatory, lucid patients were randomized to treatment with a unipolar or a bipolar hemiarthroplasty for an acute femoral neck fracture. Migration of the prosthetic head into the acetabulum was measured using RSA. Secondary outcomes were Harris Hip Score (HHS), and EQ-5D scores. Patients were assessed at 3, 12. and 24 months.Results — 19 patients were available for follow-up at 2 years: mean proximal penetration was 0.83 mm in the unipolar group and 0.24 mm in the bipolar group (p = 0.01). Mean total point movement was 1.3 mm in the unipolar group and 0.95 mm in the bipolar group (p = 0.3). Median HHS was 78 (62–96) in the unipolar group and 100 (70–100) in the bipolar group (p = 0.004). Median EQ-5D Index Score was 0.73 (0.52–1.00) in the unipolar group and 1.00 (0.74–1.00) in the bipolar group (p = 0.01). Median EQ-5D VAS was 70 (50–90) in the unipolar group and 89 (70–95) in the bipolar group (p = 0.03)Interpretation — Patients with unipolar hemiarthroplasties had higher proximal cartilage wear and lower functional outcomes. Unipolar hemiarthroplasties should be used with caution in ambulatory, lucid patients.

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Section: Interventionmentioning

confidence: 99%

Higher cartilage wear in unipolar than bipolar hemiarthroplasties of the hip at 2 years: A randomized controlled radiostereometric study in 19 fit elderly patients with femoral neck fractures

et al. 2018

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“…Using undersized bipolar heads was avoided so there would not be increased polar wear and acetabular erosion that was claimed by Paolo et al 12. The authors also used the full circular template measuring system to get the most accurate head size because using the caliper measuring system underestimates the head size as claimed by Jeffery et al 13. The implant used for the DMTHA group was Serf NOVAE Evolution cementless DM cup (Serf, Dècines-Charpieu, France) and Zimmer Biomet Exception cementless stem (Zimmer Biomet, Warsaw, Indiana).…”

Section: Methodsmentioning

confidence: 99%

“…Caution was taken not to use an oversized bipolar head, and the joint was found to be relatively lax 11 in order not to overstuff the joint to minimize the acetabular wear as much as possible. Using undersized bipolar heads was avoided so there would not be increased polar wear and acetabular erosion that was claimed by Paolo et al 12 The authors also used the full circular template measuring system to get the most accurate head size because using the caliper measuring system underestimates the head size as claimed by Jeffery et al 13 The implant used for the DMTHA group was Serf NOVAE Evolution cementless DM cup (Serf, Dècines-Charpieu, France) and Zimmer Biomet Exception cementless stem (Zimmer Biomet, Warsaw, Indiana). The follow-up was for 2 yr and included the HHS to assess the function.…”

Section: Data Collectionmentioning

confidence: 99%

Functional outcome after dual mobility cups total hip replacement versus bipolar hemiarthroplasty in femoral neck fractures in active elderly patients: a randomized controlled trial

Makeen

Mohamed

Mohasseb

et al. 2021

Current Orthopaedic Practice

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Background:Bipolar hemiarthroplasty (BA) has long been the preferred treatment and is performed in most patients with femoral neck fracture (FNF). The dual mobility cup total hip arthroplasty (DMTHA) has emerged as a relevant alternative to BA. Since then there is an on-going debate on the best implant to use. Age, comorbidities, patient independence, and potential surgical complications must be considered when choosing implants. The risk of dislocation is a crucial factor because of its important consequences. The authors evaluated the functional and mechanical outcomes of BA versus DMTHA in FNF in active elderly patients. Methods:This study was a randomized comparative interventional singleblinded study that was performed at Ain Shams University Hospitals. A total of 33 patients underwent DMTHA or BA after displaced FNF. Primary outcomes were functional outcome and postoperative dislocation rate. Secondary outcomes were operative time and amount of blood loss. Results:There were no significant differences between the demographic data and preoperative parameters between the two groups. There was a significant difference in the postoperative Harris Hip Score (HHS) between the two groups (P = 0.01). VAS of groin pain was significantly different between the two groups (P < 0.001). There was no significant difference between the two groups regarding the dislocation rate. Conclusions:The authors concluded that DMTHA offered a better functional outcome than BA with no significant complications or mortality, and there was no significant difference between DMTHA and BA in the rate of dislocation.

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“…The femoral head was considered to be a perfect sphere with a mean diameter of 47 mm [11] and centered at the origin of a right-handed three-dimensional Cartesian coordinate system. Axes xyz (Figures 1 and 2) correspond to an AP view where the anteversion angle has been cancelled out by internally rotating the hip.…”

Section: Methodsmentioning

confidence: 99%

What Is the Relevance of the Tip-Apex Distance as a Predictor of Lag Screw Cut-Out?

et al. 2013

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Using a simple mathematical formulation, the relationship between the position of the lag screw tip (relevant to both intramedullary and extramedullary devices) and the concept of tip-apex distance (TAD) was derived. TAD is widely used in operating theaters as a surgical guideline in relation to the fixation of trochanteric fractures, and in clinical studies as a predictor of lag screw cut-out. In order to visualize better this concept, the locus of points having the same TAD was plotted and the dependence of TAD on the location of the lag screw tip was also reported. It was shown that TAD should be adjusted for the size of the femoral head (a variable which varies a lot according to the sex of the patient) while no correlation was found between TAD and bone morphometry indices obtained from micro-CT data (BV/TV and Tb.Th). Therefore, these results seem to suggest that TAD lacks mechanical justification and that predictors which are based on mechanical properties, such as bone density, should be investigated further.

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Femoral head measurement in hemiarthroplasty: assessment of interobserver error using 3 measuring systems

Cited by 13 publications

References 4 publications

Higher cartilage wear in unipolar than bipolar hemiarthroplasties of the hip at 2 years: A randomized controlled radiostereometric study in 19 fit elderly patients with femoral neck fractures

Higher cartilage wear in unipolar than bipolar hemiarthroplasties of the hip at 2 years: A randomized controlled radiostereometric study in 19 fit elderly patients with femoral neck fractures

Functional outcome after dual mobility cups total hip replacement versus bipolar hemiarthroplasty in femoral neck fractures in active elderly patients: a randomized controlled trial

What Is the Relevance of the Tip-Apex Distance as a Predictor of Lag Screw Cut-Out?

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