Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures: A pooled analysis of 30,250 participants data

Imam, Mohamed A.; Shehata, Mohamed; Abd-Allah, Adel R. A.; Ahmed, Hussien; Kader, Nardeen; Ernstbrunner, Lukas; Narvani, A; Kambouroglou, Gregoris; McNamara, Iain; Sallam, Asser

doi:10.1016/j.injury.2019.06.004

Cited by 19 publications

(4 citation statements)

References 50 publications

(85 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…a bipolar ha may be advantageous in more functionally demanding patients due to less acetabular erosion and a lower revision rate compared to unipolar ha. [24][25][26] subgroup analyses in the most recent meta-analysis published before the health trial showed that the advantage for tha in reoperations was driven by comparison with unipolar ha. 6 this finding may be explained by the use of older, inferior ha implants.…”

Section: Discussionmentioning

confidence: 99%

Who, if anyone, may benefit from a total hip arthroplasty after a displaced femoral neck fracture?

et al. 2022

View full text Add to dashboard Cite

Aims The aim of this study was to explore the functional results in a fitter subgroup of participants in the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial to determine whether there was an advantage of total hip arthroplasty (THA) versus hemiarthroplasty (HA) in this population. Methods We performed a post hoc exploratory analysis of a fitter cohort of patients from the HEALTH trial. Participants were aged over 50 years and had sustained a low-energy displaced femoral neck fracture (FNF). The fittest participant cohort was defined as participants aged 70 years or younger, classified as American Society of Anesthesiologists grade I or II, independent walkers prior to fracture, and living at home prior to fracture. Multilevel models were used to estimate the effect of THA versus HA on functional outcomes. In addition, a sensitivity analysis of the definition of the fittest participant cohort was performed. Results There were 143 patients included in the fittest cohort. Mean age was 66 years (SD 4.5) and 103 were female (72%). No clinically relevant differences were found between the treatment groups in the primary and sensitivity analyses. Conclusion This analysis found no differences in functional outcomes between HA and THA within two years of displaced low-energy FNF in a subgroup analysis of the fittest HEALTH patients. These findings suggest that very few patients above 50 years of age benefit in a clinically meaningful way from a THA versus a HA early after injury. Cite this article: Bone Jt Open 2022;3(8):611–617.

show abstract

Section: Discussionmentioning

confidence: 99%

Who, if anyone, may benefit from a total hip arthroplasty after a displaced femoral neck fracture?

et al. 2022

View full text Add to dashboard Cite

show abstract

“…[6,12] Klinik çalışmalar ise bipolar protezler ile modüler unipolar protezlerin sonuçlarının benzer olduğunu göstermektedir. [23] Günümüzde, hemiartroplastinin ileri yaş, komorbid, düşkün ve fonksiyonel kapasitesi kısıtlı hastalarda uygulandığı düşünüldüğünde, maliyeti daha düşük olan unipolar başlar ile uygulamanın yeterli olacağı görülmektedir. [23] Son olarak, kalça kırıklı hastalarda diğer bir artroplasti alternatifi de 'dual mobil' veya 'tripolar' olarak isimlendirilen, TKA'nin asetabular yüzeyini, hemiartroplastinin de büyük, bipolar baş özelliğini beraberinde taşıyan eklemleşmelerdir.…”

Section: Hemiartroplasti Ve Total Kalça Artroplastisinde Cerrahi Yaklunclassified

“…[23] Günümüzde, hemiartroplastinin ileri yaş, komorbid, düşkün ve fonksiyonel kapasitesi kısıtlı hastalarda uygulandığı düşünüldüğünde, maliyeti daha düşük olan unipolar başlar ile uygulamanın yeterli olacağı görülmektedir. [23] Son olarak, kalça kırıklı hastalarda diğer bir artroplasti alternatifi de 'dual mobil' veya 'tripolar' olarak isimlendirilen, TKA'nin asetabular yüzeyini, hemiartroplastinin de büyük, bipolar baş özelliğini beraberinde taşıyan eklemleşmelerdir. Özellikle çıkık riskinin yüksek olduğu hastalarda TKA ve hemiartroplastiye iyi bir alternatif olarak düşünülmelidir.…”

Section: Hemiartroplasti Ve Total Kalça Artroplastisinde Cerrahi Yaklunclassified

Hangi kalça kırığında endoprotez; parsiyel mi, total mi?

Yıldız¹,

Ağır²

2021

TOTBID

View full text Add to dashboard Cite

“…Review studies have reported less pain, improved mobility, and long-term survivorship with cemented stems over uncemented stem prosthesis [ 4 ]. Further, a recent meta-analysis has also reported better range of motion, lower rates of acetabular erosion, and lower reoperation rates for bipolar prosthesis compared to the unipolar variant, but at the expense of longer operative time [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Is Modular Prosthesis Superior to Monoblock Variant in Hemiarthroplasty for Fracture Neck of Femur?

Paul,

Riyaz

2024

jocr

View full text Add to dashboard Cite

Introduction: The incidence of hip fractures is increasing every year worldwide. Even though hemiarthroplasty is one of the most common procedures performed for a fractured neck of the femur, there is very little research comparing the outcomes of monoblock and modular systems, the two most commonly used prostheses in neck of the femur fractures. It was hypothesized that in narrow femoral canals, the single-size monoblock stem would be more difficult to insert and lead to complications like limb lengthening and intra-operative calcar fractures. The objective of our study was to compare the outcomes of a modular prosthesis with that of a monoblock prosthesis in a fractured neck of the femur. Materials and Methods: This study analyzed the surgical outcomes of 192 cases of hemiarthroplasties performed over a 4-year period using a modular system and compared it to 192 cases performed using a single-sized monoblock system. Results: The monoblock systems were more likely to cause post-operative limb lengthening compared to their modular counterparts (P = 0.01). The incidence of intra-operative fractures was also more in the monoblock system, although it was not statistically significant. Up to 45% of patients required a femoral stem size smaller than the single-sized monoblock system as the optimum size for their femoral canals, which was available only in the modular system Conclusions: Modular prosthesis was found to have lower chances of post-operative limb lengthening and lower chances of intraoperative calcar fractures compared to monoblock prosthesis. Careful pre-operative radiologic planning is essential in cases where monoblock systems are used, and the modular system might serve as a viable solution in such scenarios. Keywords: Hip fracture, hemiarthroplasty, modular, monoblock, lengthening, complications.

show abstract

Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures: A pooled analysis of 30,250 participants data

Cited by 19 publications

References 50 publications

Who, if anyone, may benefit from a total hip arthroplasty after a displaced femoral neck fracture?

Who, if anyone, may benefit from a total hip arthroplasty after a displaced femoral neck fracture?

Hangi kalça kırığında endoprotez; parsiyel mi, total mi?

Is Modular Prosthesis Superior to Monoblock Variant in Hemiarthroplasty for Fracture Neck of Femur?

Contact Info

Product

Resources

About