A femoral head prosthesis with a built-in joint. A radiological study of the movements of the two components

Verberne, G. H. M.

doi:10.1302/0301-620x.65b5.6643555

Cited by 78 publications

(41 citation statements)

References 10 publications

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“…In a mean follow-up period of 23.5 months, two-thirds of bipolar prostheses behaved like unipolar prostheses, moving only from the outer articular surfaces. In previous studies, a decrease in inner bearing motion over time was reported (15,16). Verberne et al (16) demonstrated cessation of inner bearing motion at the third postoperative month, and Chen et al (15) reported similar findings at the second postoperative year.…”

Section: Discussionmentioning

confidence: 84%

“…In a recent Cochrane review, there was no difference in acetabular erosion between unipolar and bipolar prostheses (24). Unipolar prostheses seem likely to lead to more acetabular erosion during long-term followup, but how long the inner bearing surface motion of bipolar prostheses will continue is debatable (15,16,25).…”

Section: Discussionmentioning

confidence: 99%

“…This should decrease the amount of acetabular erosion, as evidenced radiologically, and reduce pain clinically. Nevertheless, studies have shown that the inner bearing loses mobility over time and that the bipolar prosthesis behaves similarly to the unipolar prosthesis (15,16). Moreover, the two-to five-fold increased cost of the bipolar prosthesis compared with the unipolar prosthesis poses the question of whether it affects quality of life and functional results in elderly patients after fractures with high mortality rates.…”

Section: Introductionmentioning

confidence: 99%

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Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Ayhan¹,

Kesmezacar²,

Karaman³

et al. 2013

Balkan Med J

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Background: The choice of prosthesis in hemiarthroplasty is controversial for geriatric patients after femoral neck fracture. We hypothesised that selection criteria for unipolar or bipolar prostheses could be constructed based on factors affecting mortality. Aims:The aims of this retrospective study were: (1) to determine the factors affecting mortality of femoral neck fracture patients ≥65 years of age; (2) to compare patient mortality rates, radiological findings, and functional outcomes according to prosthesis type (unipolar or bipolar); and (3) to evaluate the persistence of inner bearing mobility of bipolar prostheses.Study Design: Retrospective comparative study. Methods:In total, 144 patients operated for hemiarthroplasty and aged ≥65 were included. We classified the patients into either unipolar or bipolar prosthesis groups. To reveal factors that affected mortality, age, sex, delay in surgery, and American Society of Anesthesiologists score were obtained from folders. Barthel Daily Living, Harris hip, and acetabular erosion scores were calculated and bipolar head movement was analysed for live patients.Results: One-year mortality was 31.94%. Age ≥75 (p=0.029), male sex (p=0.048), and delay in surgery ≥6 (p=0.004) were the patient characteristics that were related to increased mortality. There were no significant differences in sex, age, American Society of Anesthesiologists score, delay in surgery, mortality, or Barthel, Harris, acetabulum scores between the two groups. Twenty patients from each group were admitted for last follow-up. Bipolar head movement was preserved for 33.3% of patients. They were inactive patients with low Barthel and Harris scores. Conclusion:Although bipolar head movement was preserved in inactive patients, we suppose that this conferred no advantage to these patients, who could hardly walk. In this study, male patients, those aged ≥75 years, and those operated at ≥6 days had an increased risk of mortality. Also, although not significant in multivariate analysis, high American Society of Anesthesiologists score (≥3) was related to increased mortality. Considering that one of three patients died during the first postoperative year, we think that these patients should be operated as soon as possible, and expensive bipolar prostheses must be used selectively in regard to patient characteristics.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Ayhan¹,

Kesmezacar²,

Karaman³

et al. 2013

Balkan Med J

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“…The Leinbach prosthesis with a solid head may accelerate wear of the acetabular cartilage [18]. For this reason some authors preferred to use a bipolar femoral prosthesis that could be converted to a total hip replacement [2,5,6].…”

Section: Discussionmentioning

confidence: 99%

Primary bipolar hemiprosthesis for unstable intertrochanteric fractures

Rodop

Kiral

Kaplan

et al. 2002

International Orthopaedics (SICOT)

118

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Between 1997 and 2001 we treated 54 elderly patients with unstable intertrochanteric fractures by primary hemiarthroplasty using a cemented bipolar prosthesis. Mean patient age was 75.6 (64-91) years and mean follow-up was 22.3 (5-48) months. Seven patients died before the fourth post-operative month. Thirty-three patients were able to walk with a walker in the first postoperative week. There were no dislocations or aseptic loosening. One deep infection was encountered after 1 year. Acetabular erosion was seen in one patient and non-union of the greater trochanter was seen in four. Five patients experienced leg-length discrepancy. We obtained 17 excellent and 14 good results after 12 months according to the Harris hip-scoring system. We observed that the inner motion of the bipolar head decreased over time.Résumé Entre 1997 et 2001 nous avons traité 54 malades âgés avec fracture intertrochanterienne instable par hémiarthroplastie utilisant une prothèse bipolaire cimentée. L'âge moyen des malades était 75.6 (64-91) années et le suivi moyen étaient 22.3 (5-48) mois. Sept malades sont morts avant le 4e mois post-opératoire. 33 malades étaient capables de marcher avec un déambulateur pendant la première semaine post-opératoire. Il n'y avait pas de luxation ni de descellement aseptique. Une infection profonde s'est manifestée après une année.Une érosion acétabulaire a été notée chez un patient et une non -consolidation du grand trochanter chez quatre patients. Cinq malades avaient une inégalité de longueur des membres inférieurs. Nous avons obtenu 17 excellents et 14 bons résultats après 12 mois d'après le score de Harris. Nous avons observé que le mouvement intérieur de la tête bipolaire a diminué avec le temps.

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“…Bateman (1974) described that the bipolar prosthesis provides two surfaces for motion, which transfer the motion of the metal head in the acetabulum to the low friction inner bearing of the prosthesis. Later, further bipolar prostheses have been developed: the Hastings Hip (Devas and Hinves, 1983), the Variokopf (Verberne, 1983), and Bi-articular hip prostheses (Franklin and Gallannaugh, 1983), which all comprise a femoral component with a spherical head that articulates with a high-density polyethylene acetabular insert, enclosed by an outer steel shell. Other design such as the Monk prosthesis (Monk, 1976) which was originally made of polyethylene alone was subsequently modified to be covered with an outer metal shell (Chen et al, 1980).…”

Section: Bipolar Hemiarthroplastymentioning

confidence: 99%

Tribology of Hemiarthroplasty

Lizhang¹

2013

Encyclopedia of Tribology

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A femoral head prosthesis with a built-in joint. A radiological study of the movements of the two components

Cited by 78 publications

References 10 publications

Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Bipolar or Unipolar Hemiarthroplasty after Femoral Neck Fracture in the Geriatric Population

Primary bipolar hemiprosthesis for unstable intertrochanteric fractures

Tribology of Hemiarthroplasty

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