Dissociation of a Bipolar Prosthesis after Right Hip Hemiarthroplasty

Grauke, Luke J.; Richardson, Michael L.

doi:10.2484/rcr.v1i4.55

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…-Joint instability (dislocated and semi-dislocated). According to other authors, this complication rate of BH is about 1.2% -3.4% [18]. There are many causes of dislocations such as soft tissue imbalance, stem looseness, uneven limbs, too large or too small head compared to acetabulum, worn acetabulum, worn Polyethylene lining, the stem stuck in the head, and especially the patient performed bad postures, etc.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2020

Ann Clin Anal Med

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Aim: In this study, we aimed to evaluate preliminary results and determine the rate of complications of bipolar hemiarthroplasty in patients aged 65 and older. Material and Methods: Patients aged 65 years and older with femoral neck fractures who underwent surgery at 7A Military Hospital from September 2013 to September 2018 were included into this study. The research is a descriptive and prospective study. Results: A total of 60 patients were studied. Aside from 1 deceased, 59 cases with 59 joints were replaced and followed up for an average of 15.3 months. Age and gender were not associated with the outcome of treatment. Implants included Zimmer 29, Serf 13, Stryker 9, and Depuy 9. There were 28 joints using cement and 32 joints cementless. The position of the stem was neutral in 54 cases, valgus in two instances, and varus in 4 cases. There were no loosen stem case. The cement technique was used in 17 cases (68%) type A and 8 cases (32%) Type B, according to Barrack classification. Clinical results according to Harris were as follows: 31 cases were very good, 12 cases were good, 5 cases were mean, and 11 cases were poor, equivalent to other authors. There were 6 cases of short limbs that reduced patient satisfaction. One case of incision infection was cleaned twice and stabilized after four weeks. One case of acetabulum worn after 32 months, but there were no clinical signs; one case dead from a stroke four weeks after the surgery without association with the operation. Discussion: Poor results are often caused by a combination of medical problems or aging. Early surgery provided better results than late surgery. There was no damage to blood vessels, nerves, fractures, or death during surgery. The bipolar hemiarthroplasty in the elderly group with very good and good rates accounted for a high proportion (72.88%). Early surgery was better (90%) compared to late surgery (69.38%). There were a few complications due to surgery.

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Section: Discussionmentioning

confidence: 99%

Untitled

2020

Ann Clin Anal Med

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“…[5] Bipolar cup dissociation is a rare complication, and only a few case reports have been published. [1][2][3][6][7][8] Although the patient characteristics and instruments used are different, an inherent factor of the modular system of the bipolar cup and femoral head is a possibility of bipolar cup dissociation.…”

Section: Discussionmentioning

confidence: 99%

“…Bipolar cup dissociation is a rare but potentially serious complication following hip hemiarthroplasty. [ 1 , 2 ] Although the articulation of bipolar cup and femoral head component is locked and strong, bipolar cup dissociation may occur, which requires revision surgery because closed reduction is impossible. [ 3 ] Unlike late bipolar cup dissociation, which occurs following wear and breakage of internal structures, such as the locking ring or liner, early bipolar cup dissociation occurs during closed reduction maneuver.…”

Section: Introductionmentioning

confidence: 99%

Be aware of the “O” sign in the bipolar cup dissociation during closed reduction of bipolar dislocation: A case report

Sim,

Son,

Shim

2023

Medicine

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Rationale: Bipolar cup dissociation following hip hemiarthroplasty is a rare complication of which only a few cases have been reported, and it usually requires revision surgery because of difficulties in closed reduction. Patient concerns: We report the case of a 57-year-old man who underwent bipolar hemiarthroplasty 2 months ago caused by a left femoral neck fracture. Postoperatively, bipolar dislocation occurred thrice, and the patient showed bipolar cup dissociation during closed reduction maneuver at the recent visit. At the time of this event, no consideration was given to the shape of the prosthesis on the radiograph. Diagnoses: The patient was diagnosed with early bipolar cup dissociation. Interventions: The patient underwent revision surgery to replace and reassemble the femoral head component. Outcomes: No further dislocation occurred following the surgery. Lessons: To avoid dissociation of the components during closed reduction, it would be helpful to have knowledge of the “O” sign, a concentric circle shape of the prosthesis on the radiograph. Level of evidence: Level V, case report.

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“…Dissociation is rare and corresponding reasons have been reported in only a few case reports. [17][18][19] The most common causes were "bottle-opener mechanism" during closed reduction and failure of the polyethylene locking ring. According to the component size, Li et al 16 reported a rate of 0.9% (four of 424) patients experiencing dissociations after HA.…”

Section: Discussionmentioning

confidence: 99%

“…We found little information regarding this rare and severe complication except a few case reports. [17][18][19] In this study, we aimed to investigate risk factors that may cause dislocation and dissociation following a bipolar hemiarthroplasty in patients with femoral neck fracture by evaluating the morphological features in addition to the patient characteristics. Further, the risk factors determined by multivariable analysis were also discussed according to the morphometric differences between dislocated and matched control patients.…”

Section: Introductionmentioning

confidence: 99%

Multivariable Analysis of Risk Factors Affecting Dislocation After Bipolar Hemiarthroplasty in Patients with Femoral Neck Fracture

Yang

et al. 2022

TCRM

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This study aimed to investigate the risk factors associated with dislocation and dissociation following bipolar hemiarthroplasty (HA) for the treatment of patients with femoral neck fractures. Methods: We retrospectively reviewed 462 patients (479 hips) treated with bipolar HA from January 2010 to January 2020. All patients received posterolateral approaches and a minimum follow-up of at least 2 years regularly. A case-control study was performed to analyze the risk factors of dislocation regarding patient demographics, coexisting diseases, surgical and morphologic features. Multivariable logistic regression analysis for independent risk factors affecting dislocation and dissociation was also performed. Results: The dislocation rate was 5.01%, and the mean time from HA to the first incident of dislocation was 38.75 days. Patientrelated factors, including operation side, prosthesis type, and neuromuscular disease, did not differ significantly. Regarding the morphological factors, a significant difference was observed in center-edge (CE) angle, abduction angle, acetabular depth, depth/ width ratio, rotation center (RC) to greater trochanter tip (GTT) vertical distance, RC to GTT vertical distance difference, RC to GTT horizontal distance, RC to GTT horizontal distance difference, offset difference, and offset discrepancy. Further, decreased CE angle, increased abduction angle, decreased RC to GTT vertical distance, decreased offset difference and increased offset discrepancy were determined to be independent risk factors of dislocation. The proportion of patients experiencing dissociation was 1.04%. All the implanted femoral heads were smaller than 43 mm, which was determined to be the risk factor of dissociation. Conclusion: Decreased CE angle, RC to GTT vertical distance, offset difference, and increased abduction angle, offset discrepancy were determined to be independent risk factors of HA dislocation. Once dislocation risk was detected by simulated templating, THA or changing surgical approach should be considered to avoid evitable perioperative complications.

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Dissociation of a Bipolar Prosthesis after Right Hip Hemiarthroplasty

Cited by 4 publications

References 15 publications

Untitled

Untitled

Be aware of the “O” sign in the bipolar cup dissociation during closed reduction of bipolar dislocation: A case report

Multivariable Analysis of Risk Factors Affecting Dislocation After Bipolar Hemiarthroplasty in Patients with Femoral Neck Fracture

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