Cementless Bipolar Hemiarthroplasty Using a Rectangular Cross-Section Stem for Unstable Intertrochanteric Fractures

Abstract

The purpose of this study was to compare the clinical and radiographic results for elderly patients sustaining unstable intertrochanteric fractures treated with an uncemented bipolar hemiarthroplasty using a double-tapered, rectangular cross-section stem. Thirty-seven patients (21 females, 16 males; mean age 73.5 years, range 65-88 years) who underwent bipolar hemiarthroplasty with a standard (double-tapered, rectangular cross-section) uncemented stem were followed up for a minimum of two years. At final follow-up, 27 patients (72.9%) had recovered their daily living ability (Barthel index), and 28 patients (75.6%) had recovered all walking ability at a community level (Koval's category).

Comparison of intramedullary fixation and arthroplasty for the treatment of intertrochanteric hip fractures in the elderly

“…Results from recent reports demonstrated that primary bipolar hemiarthroplasty allowed patients to ambulate earlier with a low failure ratio. [29,30] And cut-out complication rates with newer design intramedullary nails were lower. [31] Although the technology of the IMF was continuously improved, the systematical review by Norris et al [32] reported that the incidence of a 2nd fracture after IMF was approximately 1.7%.…”

Midterm outcome analysis of bipolar hemiarthroplasty for unstable intertrochanteric femur fractures: A retrospective study

“…Recently, the cementless stem has been widely used for hip arthroplasty and there have been many studies reporting good results for unstable intertrochanteric fractures [3][4][5][6][7][8][9]. However, studies evaluating the long-term outcomes patients who have survived for over five years or femoral stems applied using different fixation methods according to each design have been small studies.…”

“…Specifically, if the type 3C stem is used for intertrochanteric fractures in which the proximal region is fractured, the bone ongrowth of the proximal region may be poorer because the fixation force is mainly obtained in the diaphysis and stable three-point fixation cannot be achieved. Some studies have reported good results with type 3C stems for unstable intertrochanteric fractures [3,7]. However, studies that report excellent results using these type 3C stems have been mostly short-term.…”

“…patients has been open reduction and internal fixation. However, primary bipolar hemiarthroplasty has been advocated as an alternative to osteosynthesis for unstable intertrochanteric fractures in the elderly, as it provides the advantages of permitting early full-weight bearing, avoiding the failures of osteosynthesis, and good functional outcomes and fewer complications [3]. Recently, various cementless stems have been developed to improve clinical outcomes and promote firm fixation.…”

“…Furthermore, the use of cementless femoral stems is increasing and various designs and surface coated methods have been used for unstable intertrochanteric fractures with good results [3][4][5][6][7][8][9].…”