Medium to Long Term Results of the Exeter Bipolar Hemiarthroplasty for Femoral Neck Fractures in Active, Independent Patients. 5–13 year follow-up

Miller, David J.; Choksey, A.; Meyer, Christian; Perkins, R. D.

doi:10.1177/112070000801800406

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…Harris hip scores were not reported in numerous studies [6,11,15,20,27] after bipolar hemiarthroplasty. However, Ritter et al [23] showed an age-related decline of the Harris hip score for THA of 0.88 points per year even when patients otherwise were doing well.…”

Section: Discussionmentioning

confidence: 98%

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Cemented Bipolar Hemiarthroplasty Provides Definitive Treatment for Femoral Neck Fractures at 20 Years and Beyond

Roth

Abdel

Harmsen

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Displaced femoral neck fractures frequently are treated with bipolar hemiarthroplasties. Despite the frequency with which bipolar hemiarthroplasty is used to treat these fractures, there are few long-term data. Questions/purposes We sought to evaluate (1) the cumulative incidence of revision for any reason of bipolar hemiarthroplasties at 20 years, and the proportion of patients who lived more than 20 years who still have the prosthesis in situ from the index arthroplasty, (2) the cumulative incidence of aseptic loosening at 20 years, and (3) the Harris hip score of the surviving patients at long term.Methods We performed 376 cemented bipolar hemiarthroplasties for displaced femoral neck fractures in 359 patients between 1976 and 1985. At a minimum of followup of 20 years (mean, 24 years; range, 20-31 years), 339 of 359 patients (94%) were deceased, leaving 20 patients in the study group. Of those, one patient was confirmed to be lost to followup and two others had radiographic followup only. Three hundred fifty-nine patients (99.2%) (376 of the original 379 hips) were followed until death, revision of the hemiarthroplasty, or for at least 20 years (of clinical followup). Bipolar hemiarthroplasty was performed for displaced femoral neck fractures. Cemented fixation was the standard of care between 1976 and 1985 at our institution. The mean age of the patients at the time of surgery was 79 years (range, 60-99 years). The cumulative incidence of revision, estimated with death as a competing risk, and radiographs were evaluated for signs of aseptic loosening by a surgeon not involved in the clinical care of the patients. Clinical function was evaluated with the Harris hip score. The mean age of the patients at the time of surgery was 79 years. Results The 20-year cumulative incidence of revision for any reason was 3.5% (95% CI, 1.6%-5.3%). Of the 20 patients who survived more than 20 years, seven had the implant intact. The 20-year cumulative incidence of revision for aseptic loosening was 1.4% (95% CI, 0.2%-2.6%). The mean Harris hip score in patients who were still living and patient who did not have revision surgery was 63 ± 22, however 13 of the 20 patients had undergone revision surgery. Conclusions The long-term survivorship of bipolar hemiarthroplasty prostheses used to treat displaced femoral neck fractures in the elderly was high, and the procedure can be considered definitive for the majority of elderly patients with a femoral neck fracture. In this series, 6%

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Section: Discussionmentioning

confidence: 98%

“…Of the patients who survived more than 20 years after the index surgery, 35% had an unrevised component in situ. Comparable studies do not report on the outcome for patients who are living and those who have not undergone revision surgery [6,11,15,20]. LaBelle et al [13] reported a 10% Fig.…”

Section: Discussionmentioning

confidence: 99%

Cemented Bipolar Hemiarthroplasty Provides Definitive Treatment for Femoral Neck Fractures at 20 Years and Beyond

Roth

Abdel

Harmsen

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…The ideal prosthesis is still debated and often depends upon surgeon, patient, and unit factors 2). Bipolar hip arthroplasty has been in use for the treatment of primary hip arthritis since 1974,4) but is most commonly now employed in the management of fractures of the proximal femur 5)…”

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The Conversion Rate of Bipolar Hemiarthroplasty after a Hip Fracture to a Total Hip Arthroplasty

et al. 2012

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BackgroundBipolar hip hemiarthroplasty is used in the management of fractures of the proximal femur. The dual articulation is cited as advantageous in comparison to unipolar prostheses as it decreases acetabular erosion, has a lower dislocation rates and is easier to convert to a total hip arthroplasty (THA) should the need arise. However, these claims are debatable. Our study examines the rate of conversion of the bipolar hemiarthroplasty to THA and the justification for using it on the basis of future conversion to THA.MethodsAll cases of bipolar hemiarthroplasty performed in our unit for hip fractures over a 9-year period (1999-2007) were reviewed. Medical notes and radiographs of all patients were reviewed, and all surviving patients that were contactable received a telephone follow-up.ResultsOf all 164 patients reviewed with a minimum of 1 year from date of surgery, 4 patients had undergone a conversion of their bipolar prosthesis to THA. Three conversions were performed for infection, dislocation, and fracture. Only one (0.6%) conversion was performed for groin pain.ConclusionsOur study show that bipolar hemiarthroplasties for hip fractures have a low conversion rate to THAs and this is comparable to the published conversion rate of unipolar hemiarthroplasties.

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Bipolar Hemiarthroplasty for Fracture Neck Femur

Joshi,

Dhukia

2023

Hip Arthroplasty

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Medium to Long Term Results of the Exeter Bipolar Hemiarthroplasty for Femoral Neck Fractures in Active, Independent Patients. 5–13 year follow-up

Cited by 4 publications

References 23 publications

Cemented Bipolar Hemiarthroplasty Provides Definitive Treatment for Femoral Neck Fractures at 20 Years and Beyond

Cemented Bipolar Hemiarthroplasty Provides Definitive Treatment for Femoral Neck Fractures at 20 Years and Beyond

The Conversion Rate of Bipolar Hemiarthroplasty after a Hip Fracture to a Total Hip Arthroplasty

Bipolar Hemiarthroplasty for Fracture Neck Femur

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