Fortyone patients above 60 years of age and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either unipolar or bipolar hemiarthroplasty, in the department of orthopaedics, between september 2009 and october 2012. Until researchers develop more advanced diagnostic procedures, dr. However, questions remain regarding the choice of unipolar or bipolar ha. When the person experiences a depressive episode only, then it is called a unipolar disorder. Bipolar hemireplacement arthroplasty for femoral neck. Osteoporosis introduction contemporary evidence from randomised. Bipolar hemiarthroplasty, total hip replacement, neglected femoral neck fracture, hip fracture introduction hip fracture is an international public health problem mainly occurring in elderly patients and resulting in a high mortality. The choice was a unipolar ha in 60% and a bipolar ha in 3233%. Unipolar or bipolar hemiarthroplasty for femoral neck. Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures.
Monopolar electrocautery monopolar electrosurgery can be used for several modalities including cut, blend, desiccation, and fulguration. Comparison of bipolar hemiarthroplasty and total hip. A person may start of being happy and then go quickly to becoming sad or depressed. Major or longterm minor depression without highs is considered unipolar depression by default.
Advantages of the unipolar prosthesis include lower cost and no risk of polyethylene wear debris. Unipolar or bipolar hemiarthroplasty in the treatment of. Comparison of unipolar hemiarthroplasty with bipolar hemiarthroplasty 7 trials, 857 participants, 863 fractures showed no significant differences between the two types of implant. Aug 28, 2015 displaced femoral neck fractures fnfs in healthy elderly patients have traditionally been managed with hemiarthroplasty ha or total hip arthroplasty tha, with studies suggesting that tha may be the better option. The decision of whether a patient receives a unipolar vs. Someone with unipolar depression doesnt go through the highs of bipolar depression. This publication is not intended for distribution in the usa. This video describes one of the most commonly done procedures for displaced fractures of femoral neck in elderly. Maletic advises that taking the time to gather and interpret complete patient, family, and treatment histories, heteroanamnesis, and temps scores 6 remains the best strategy for clinicians to differentiate bipolar disorder from unipolar depression. The choice of prosthesis in hemiarthroplasty is controversial for geriatric patients after femoral neck fracture. The height of the trial is less than the height of the implant by 0. The movements in the inner and outer bearings are complementary to each other 2. Cemented bipolar hemiarthroplasty in osteopetrosis for failed femoral neck fixation rajiv gandhi, md mohammadreza salehi, md j.
Feb 08, 2011 the secondary aim was to analyse the degree of acetabular erosion and its influence upon outcome. Only prospective randomized controlled trials rcts. There are two types of options, including unipolar hemiarthroplasty uh and bipolar hemiarthroplasty bh, when using a hemiarthroplasty. Bipolar has displayed a later onset of acetabular erosion compared to unipolar has. Hemiarthroplasty of the hip physical therapy in seattle. Click here to learn about hip hemiarthroplasty bipolar, which is performed by the specialtytrained doctors at orthopedic associates in port huron, michigan. Bipolar hemiarthroplasty in elderly patients presenting. Bipolar hemiarthroplasty in elderly patients presenting with.
Hemiarthroplasty unipolar and bipolar indications approach and procedure moderator. Dislocation of a hemiarthroplasty is uncommon and has a reported overall rate of approximately 3. Due to the unsatisfactorily high level of uncertainty, this. Changes in implant choice and surgical technique for. Hip replacement surgery can be performed as a total replacement or a hemi half replacement. Displaced femoral neck fractures fnfs in healthy elderly patients have traditionally been managed with hemiarthroplasty ha or total hip arthroplasty tha, with studies suggesting that tha may be the better option. O steopetrosis refers to a group of disorders characterized by severe impairment of osteoclastmediated bone resorption. Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Nov 11, 2015 hip replacement using hemiarthroplasty ha is a common surgical procedure in elderly patients with femoral neck fractures. Unipolar versus bipolar hemiarthroplasty for displaced.
Pdf unipolar versus bipolar hemiarthroplasty for displaced. The graters, cup trials and actual deltamotion cups are all a full hemisphere of 180. To assess the safety and efficacy that compare bipolar hemiarthroplasty with unipolar hemiarthroplasty for the treatment of femoral neck fracture in the patient aged more than 65 years. Comparison of different types of artificial hip joints. How does unipolar depression differ from bipolar depression. The hip coxofemoral joint is a large and stable diarthroidal ballandsocket joint formed by the articulation between the femoral head and the. Roderick davey, md from the department of surgery, university health network, toronto, ont. Among patients who were able to walk unaided before injury, more of those having bipolar hemiarthroplasty were able to do so at month 4 than those having unipolar hemiarthroplasty % vs. Dislocation and dissociation of bipolar hip hemiarthroplasty.
Hemiarthroplasty and total hip arthroplasty in 30,830. Mbbs singapore, mrcs edinburgh mrcs edinburgh, mmed. Hemi means half, and arthroplasty means joint replacement. A total hip replacement total hip arthroplasty or tha consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Always refer to t he package insert, product label ando. The decision to perform hemiarthroplasty using a unipolar or bipolar prosthesis remains controversial, with proponents on either side.
Uncemented austinmoore and cemented thompson unipolar. Fortyone patients above 60 years of age and an acute displaced fracture of the femoral neck were. To the best of our knowledge, this is the first rct that systematically analyses acetabular erosion after unipolar ha and bipolar ha using a modern hemiarthroplasty with identical stems in both groups. In 2009, however, the use of unipolar modular implants increased above the level of use of bipolar modular implants 56% vs. Many randomized, controlled trials rcts have evaluated the benefits of bipolar hemiarthroplasty ha vs unipolar ha, but there is inconsistency across. Hip hemiarthroplasty bipolar orthopedic associates of. The cox model in a multivariable approach with more covariables produces hazard ratios hr with 95% confidence intervals ci. Tantalum markers are placed around the acetabulum during surgery.
No significant differences were found between the unipolar and bipolar groups. Using a pencil instrument, the active electrode is placed in the entry site and can be used to cut tissue. Difference between bipolar and unipolar bipolar vs unipolar. The hemiarthroplasty replaces only the ball portion of the hip joint, not the socket portion. That unipolar head is rubbing directly on the acetabulum. It has been noted that patients undergoing hemiarthroplasty for fracture of. Hemiarthroplasty is a common procedure in the treatment of femoral neck fractures in the elderly. Hemiarthroplasty is the procedure of choice unipolar vs. Conclusion the bipolar has seem to result in better hrqol beyond the first two years after surgery compared to unipolar has. One group receives a unipolar hemiarthroplasty and 15 receives a bipolar arthroplasty. Hip replacement is currently one of the most common orthopaedic operations, though patient satisfaction short and longterm varies widely.
Hemiarthroplasty and total hip arthroplasty in 30,830 patients with hip fractures. The aim of this study was to evaluate hip function, health related quality of life hrqol, surgical outcome. Depressed mood, anhedonia, significant weight loss or weight gain 5% in a month. So this type of head is good for older patients that have a very low activity level. What are the differences between bipolar and unipolar cautery. Hip dislocation after modular unipolar hemiarthroplasty christopher c. Among these procedures, hemiarthroplasty has become the most preferred treatment option for surgeons according to the surveys. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures.
Unipolar versus bipolar hemiarthroplasty 7 subjects and methods the present study is of intracapsular fracture neck of femur in elderly patients above the age of 60 years, irrespective of gender, treated with hemiarthroplasty using uncemented unipolar austin moores prosthesis amp in 20 patients and. We conducted an audit to determine the mortality and complication rates as well as patient satisfaction in two groups of patients at a district general hospital in uk, one group receiving uncemented austinmoore unipolar hemiarthroplasty and the other cemented thompson unipolar hemiarthroplasty for displaced fractures of the neck of femur. This surgical procedure replaces the head of a damaged femur with an implant designed to stabilize the femur and restore hip function. A recent metaanalysis of rcts comparing unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures did not fi nd an advantage of bipolar prostheses jia 2015.
Performing a hemiarthroplasty rather than a total hip arthroplasty in our defined patient population may put the patient at a higher risk for morbidity and future complications. The information presented in this brochure is intended to demonstrat e the breadth of stryker product offerings. Unipolar versus bipolar hip hemiarthroplasty in the treatment. Furthermore, in a longterm study, soreide et al show that protrusion is a complication of unipolar hemiarthroplasty in 54% of cases studied26. Below is a closer look at the symptoms of both depression and mania. Particles are charged by unipolar or bipolar ions produced by. Bipolar or unipolar hemiarthroplasty after femoral neck.
The femoral head can be replaced two 2 different ways, either as unipolar or bipolar. The cemented and uncemented group did not differ significantly in terms of age, sex, and comorbidities. Cemented bipolar hemiarthroplasty in osteoporosis for. If you or someone you know is experiencing these symptoms, its important to visit your counseling center or a mental health professional to get the right diagnosis and treatment. Hip hemiarthroplasty unipolar versus bipolar hip hemiarthroplasty in the treatment of femoral neck fractures in the elderly ali a. Factors that could play a role in decisionmaking include patient age, activity level, and associated medical conditions. Conclusion based on the results of this study, there does not appear to be any advantage to the use of a bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly.
A hemiarthroplasty procedure results in less surgical time and less blood loss than a thr. Hemiarthroplasty half joint replacement hemiarthroplasty involves replacing the femoral head with a prosthesis, while. Proposed advantages of the bipolar prosthesis include less acetabular wear and potentially less hipgroin pain. In a unipolar hemiarthroplasty only the prosthetic femoral head articulates in the acetabulum, only one point of movement uni 1 in a bipolar hemiarthroplasty there are. The aim of this study was to compare the outcome of unipolar with the bipolar prosthesis in geriatric patients.
Unipolar vs bipolar hemiarthroplasty dennis zw ng and kevin bl lee 198 materials and methods all patients who underwent hemiarthroplasty for displaced neck of femur fractures between 1 january 2004 and 31 december 2007 were analysed from a log of all operative procedures. How to differentiate bipolar disorder from unipolar. Hip dislocation after modular unipolar hemiarthroplasty. A hemiarthroplasty is an operation that is used most commonly to treat a fractured hip. The operation is similar to a total hip replacement but it involves only half of the hip. Bipolar hemiarthroplasty is done using a low friction, total prosthesis that has motion at two bearings unlike the unipolar prosthesis. A systematic literature search up to april, 2014 was conducted to include rcts comparing bh with uh for. The type of mental illness in which the patient displays abnormal behavior is called a mental disorder. Unipolar and bipolar diffusion charging of ultrafine. The secondary aim was to analyse the degree of acetabular erosion and its influence upon outcome.
The present study is of intracapsular fracture neck of femur in elderly patients above the age of 60 years, irrespective of gender, treated with hemiarthroplasty using uncemented unipolar austin moores prosthesis amp in 20 patients and bipolar endoprosthesis in 21 patients, in the department of orthopaedics at kempegowda institute of medical sciences kims. The main outcome measure evaluated was dislocation vs nondislocation. We hypothesised that selection criteria for unipolar or bipolar prostheses could be constructed based on factors affecting mortality. Unipolar depression is a mental disorder that results in a patient having episodes of lowmood, low selfesteem, loss of interest, loss of pleasure in enjoyable activities. Unipolar vs bipolar hemiarthroplastydennis zw ng and kevin bl lee 198 materials and methods all patients who underwent hemiarthroplasty for displaced neck of femur fractures between 1 january 2004 and 31 december 2007 were analysed from a log of all operative procedures. The poly is packaged inside the shell so first thing to do is to use liner release forceps to remove liner from shell then place poly insert on head. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty.
Oct 12, 20 the treatment of choice for a displaced femoral neck fracture in the most elderly patients is a cemented hemiarthroplasty ha. However, it has recently been reported that bipolar ha bha also provides good outcomes, and it is not clear as to whether bha or tha is most appropriate. Hemiarthroplasty can be divided into unipolar and bipolar. The optimal design, unipolar or bipolar head, remains unclear. Functional outcome of cemented versus uncemented modular. The choice between unipolar and bipolar hemiarthroplasty for treatment of displaced intracapsular femoral neck fractures in elderly patients still remains controversial. However, the choice between a unipolar and a bipolar ha is controversial and difficult to make. The outcome of austin moor vs bipolar hemiarthoplasty in elderly patients in terms of harris hip score and charnley hip score mian muhammad azhar abstract aim. Journal of orthopaedic surgery and research, jan 2015. A metaanalysis chen jiangtao1, zhou yijun2, xun chuanhui1, huo jianjun3, song xinghua1, tian zheng1, akbar yunus1, cao li1 1orthopaedic department, the first affiliated hospital of xinjiang medical university, urumqi 2orthopaedic department, the first peoples. They found no difference in functional outcomes between unipolar and bipolar prostheses.
We searched databases including pubmed central, medline from 1966, embase from 1980 and the cochrane central register of controlled trials database. Surgical technique selfcentering bipolar and modular cathcart unipolar endo heads depuy synthes 3 assembly selfcentering bipolar modular cathcart unipolar note. Whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty uh remains controversial. Bipolar disorder is a condition in which people experience extensive mood swings. Unlike total hip replacement, in which both the ball of the femur and the hip socket are replaced, in this procedure, only the ball is replaced. Unipolar versus bipolar uncemented modular hemiarthroplasty. Furthermore, the extra cost of bipolar endoprostheses does not seem. Seven trials involving 734 participants compared hemiarthroplasty with a total hip replacement thr. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the most elderly patients with displaced femoral neck fractures. However, there is inadequate evidence to support the choice between unipolar or bipolar hemiarthroplasty. Avoid bipolar hip conversion coding errors published on wed dec 01, 1999 the number of claims for hip replacement and bipolar hip conversion procedures is on the rise, according to statistics from the american academy of orthopaedic surgeons aaos. The possible advantages of a bipolar ha are a better range of motion and less acetabular wear.
Jan 24, 2015 whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty uh remains controversial. Ninh, md, anil sethi, md,y mohammed hatahet, md, clifford les, phd, massimo morandi, md, and rahul vaidya, md, frcscy abstract. Tight fit bipolar hip arthroplasty in avn hip in young adults by baldev dudani. Unipolar and bipolar diffusion charging of monodisperse aerosol particles of 4100 nm in diameter has been studied experimentally and theoretically. Introduction device compatibility 2 sleeve offsets 2 overview of implant sizing 4 cup positioning 5 preoperative planning xray templating 6 surgical technique step 1. The difference between unipolar and bipolar depression is defined by the symptoms of unipolar depression. Although the diagnosis is more complex than that, it does serve as a starting point. The outcome of austin moor vs bipolar hemiarthoplasty in. Proposed advantages of the bipolar prosthesis include. Due to the unsatisfactorily high level of uncertainty, this study was undertaken to analyze the relationship between perioperative parameters, functional outcome and complications of bipolar hemiarthroplasty in elderly patients with displaced intracapsular femoral neck fractures and to. To determine the outcome of hemiarthroplasty using unipolar and bipolar prosthesis and to evaluate their results in terms of harris hip score and charnley hip score. In a total hip replacement the socket is also replaced. Hemiarthroplasty total hip arthroplasty treatment algorithm femoral neck fracture hip arthroplasty. A systematic literature search up to april, 2014 was conducted to include rcts comparing bh with uh.
1428 322 452 802 368 1171 925 240 314 674 225 344 1108 915 630 614 567 1194 1290 1501 428 685 361 1247 28 103 1429