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Results of Cementless and Cemented Bipolar Hemiarthroplasty in Proximal Femur Fractures with Dorr Type B Morphology

Year 2022, Volume: 11 Issue: 3, 361 - 367, 04.10.2022

Muhammed Çağatay Engin Serdar Toy Kemal Zencirli Mehmet Cenk Turgut

https://doi.org/10.53424/balikesirsbd.1029509

Abstract

Objective: Surgical outcomes of patients with Dorr type B femoral morphology operated for hip fracture with bipolar hemiarthroplasty were compared. Materials and Methods: This retrospective study included 255 patients with a follow-up of at least five years. Patients were divided into two groups: cementless (group 1; n=87) and cemented (group 2; n=168). The study focused on the following parameters: Admission cost, fracture type, gender, need for blood transfusion, Harris Hip Score (HHS), additional fracture, use of cement, mortality rate, revision surgery, the time between trauma and surgery, length of hospital stays, and surgery time. Results: The mean age of patients was similar in both groups. Group 2 had a significantly longer duration of surgery and a higher need for blood transfusions than group 1. The mean hemoglobin levels of patients were similar in both groups. Pertrochanteric femoral fractures were more common than femoral neck fractures in group 2. The two groups did not differ on the parameters of time between trauma and surgery, mortality rate, revision surgery, length of hospital stay, cost, and additional fractures. Conclusion: In patients aged 75 years or older who are scheduled for cemented bipolar hemiarthroplasty, erythrocyte suspension preparation should be performed before surgery if a hip fracture with Dorr type B femoral morphology is present.

Keywords

Elderly Hemiarthroplasty Hip Hip Fractures

References

  • Anderson, L. D., Hamsa JR, W. R., & Waring, T. L. (1964). Femoral-head prostheses: A review of three hundred and fifty-six operations and their results. J Bone Joint Surg Am., 46(5), 1049-1065.
  • Barenius, B., Inngul, C., Alagic, Z., & Enocson, A. (2018). A randomized controlled trial of cemented versus cementless arthroplasty in patients with a displaced femoral neck fracture: a four-year follow-up. Bone Joint J, 100(8), 1087-1093.
  • DeCarlo, L. T. (1997). On the meaning and use of kurtosis. Psychol Methods, 2(3), 292.
  • Dorr, L. D., Faugere, M.-C., Mackel, A. M., Gruen, T. A., Bognar, B., & Malluche, H. H. (1993). Structural and cellular assessment of bone quality of proximal femur. Bone, 14(3), 231-242.
  • Fan, L., Dang, X., & Wang, K. (2012). Comparison between bipolar hemiarthroplasty and total hip arthroplasty for unstable intertrochanteric fractures in elderly osteoporotic patients. PLoS One, 7(6), e39531.
  • Frenken, M., Schotanus, M., van Haaren, E., & Hendrickx, R. (2018a). Cemented versus uncemented hemiarthroplasty of the hip in patients with a femoral neck fracture: a comparison of two modern stem design implants. Eur J Orthop Surg Traumatol., 28(7), 1305-1312.
  • Frenken, M., Schotanus, M., Van Haaren, E., & Hendrickx, R. (2018b). Cemented versus uncemented hemiarthroplasty of the hip in patients with a femoral neck fracture: a comparison of two modern stem design implants. Eur J Orthop Surg Traumatol., 28(7), 1305-1312.
  • Groeneveld, R. A., & Meeden, G. (1984). Measuring skewness and kurtosis. J. R. Stat. Soc., Ser. D Stat. (Online), 33(4), 391-399.
  • Guyen, O. (2019). Hemiarthroplasty or total hip arthroplasty in recent femoral neck fractures? Orthop Traumatol Surg Res., 105(1), S95-S101.
  • Haentjens, P., Autier, P., Barette, M., & Boonen, S. (2001). The economic cost of hip fractures among elderly women: a one-year, prospective, observational cohort study with matched-pair analysis. J Bone Joint Surg Am., 83(4), 493.
  • Holt, E., Evans, R., Hindley, C., & Metcalfe, J. (1994). 1000 femoral neck fractures: the effect of pre-injury mobility and surgical experience on outcome. Injury., 25(2), 91-95.
  • Hopkins, K. D., & Weeks, D. L. (1990). Tests for normality and measures of skewness and kurtosis: Their place in research reporting. Educ Psychol Meas, 50(4), 717-729.
  • Inngul, C., Blomfeldt, R., Ponzer, S., & Enocson, A. (2015). Cemented versus uncemented arthroplasty in patients with a displaced fracture of the femoral neck: a randomised controlled trial. Bone Joint J., 97(11), 1475-1480.
  • Kiran Kumar, G., Meena, S., Kumar, V., Manjunath, S., & Mk, V. R. (2013). Bipolar hemiarthroplasty in unstable intertrochanteric fractures in elderly: a prospective study. J Clin Diagn Res., 7(8), 1669.
  • Lu-Yao, G. L., Keller, R. B., Littenberg, B., & Wennberg, J. E. (1994). Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am, 76, 15-25.
  • Mahomed, N. N., Arndt, D. C., McGrory, B. J., & Harris, W. H. (2001). The Harris hip score: comparison of patient self-report with surgeon assessment. J Arthroplasty., 16(5), 575-580.
  • McKinley, J., & Robinson, C. (2002). Treatment of displaced intracapsular hip fractures with total hip arthroplasty: comparison of primary arthroplasty with early salvage arthroplasty after failed internal fixation. J Bone Joint Surg Am., 84(11), 2010-2015.
  • Melton III, L. J., Crowson, C., & O’fallon, W. (1999). Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int., 9(1), 29-37.
  • Miyamoto, S., Nakamura, J., Iida, S., Shigemura, T., Kishida, S., Abe, I., Takeshita, M., Otsuka, M., Harada, Y., & Orita, S. (2018). The influence of bone cement and American Society of Anesthesiologists (ASA) class on cardiovascular status during bipolar hemiarthroplasty for displaced femoral-neck fracture: A multicenter, prospective, case-control study. Orthop Traumatol Surg Res., 104(5), 687-694.
  • Moors, J. J. A. (1986). The meaning of kurtosis: Darlington reexamined. Am Stat, 40(4), 283-284.
  • Moran, C. G., Wenn, R. T., Sikand, M., & Taylor, A. M. (2005). Early mortality after hip fracture: is delay before surgery important? J Bone Joint Surg Am., 87(3), 483-489.
  • Muirhead-Allwood, W., Hutton, P., & Glasgow, M. (1983). A comparative study of cemented and uncemented Thompson prosthesis. J Bone Joint Surg Br., 65(2), 218-219.
  • Nash, W., & Harris, A. (2014). The Dorr type and cortical thickness index of the proximal femur for predicting peri-operative complications during hemiarthroplasty. J Orthop Surg (Hong Kong). 22(1), 92-95.
  • Ong, B. C., Maurer, S. G., Aharonoff, G. B., Zuckerman, J. D., & Koval, K. J. (2002). Unipolar versus bipolar hemiarthroplasty: functional outcome after femoral neck fracture at a minimum of thirty-six months of follow-up. J Orthop Trauma. , 16(5), 317-322.
  • Parker, M., & Johansen, A. (2006). Hip fracture. Bmj, 333(7557), 27-30.
  • Rogmark, C., Carlsson, Å., Johnell, O., & Sernbo, I. (2003). Costs of internal fixation and arthroplasty for displaced femoral neck fractures. Acta Orthop Scand. , 74(3), 293-298.
  • Sah, A. P., Thornhill, T. S., LeBoff, M. S., & Glowacki, J. (2007). Correlation of plain radiographic indices of the hip with quantitative bone mineral density. Osteoporos Int., 18(8), 1119-1126.
  • Seckin, B. (2003). Kollum Femoris Kırıklarında Unipolar ve Bipolar Parsiyel Protezlerin Karşılaştırılması
  • Singh, M., Nagrath, A. R., & Maini, P. S. (1970). Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. J Bone Joint Surg Am., 52(3), 457-467.
  • Sonar, U. V., Ingle, M. V., Koichade, M. R., Yelne, A. B., & Malu, N. (2014). Comparative study between trochanteric fixation nailing and cemented bipolar hemiarthroplasty for the treatment of unstable osteoporotic intertrochanteric neck femur fractures in elderly patients. IOSR J Dent Med Sci, 3, 31-40.
  • Weinrauch, P. (2006). Intra-operative error during Austin Moore hemiarthroplasty. J Orthop Surg (Hong Kong). 14(3), 249-252.

Dorr Tip B Morfolojili Proksimal Femur Kırıklarında Çimentosuz ve Çimentolu Bipolar Hemiartroplasti Sonuçları

Year 2022, Volume: 11 Issue: 3, 361 - 367, 04.10.2022

Muhammed Çağatay Engin Serdar Toy Kemal Zencirli Mehmet Cenk Turgut

https://doi.org/10.53424/balikesirsbd.1029509

Abstract

Amaç: Bipolar hemiartroplasti ile kalça kırığı nedeniyle ameliyat edilen Dorr tip B femur morfolojisine sahip hastaların cerrahi sonuçları karşılaştırıldı. Gereç ve Yöntem: Bu retrospektif çalışmada, en az 5-yıllık takibi olan 255 hasta değerlendirildi. Hastalar iki gruba ayrıldı: sementsiz (Grup 1; n=87) ve sementli (Grup 2; n=168). Çalışma şu parametrelere odaklandı: yatış maliyetleri, kırık tipi, cinsiyet, kan transfüzyonu ihtiyacı, Harris hip skoru (HHS), ek kırık, çimento kullanımı, ölüm oranı, revizyon cerrahisi, travma ile cerrahi arasındaki süre, hastanede kalış süresi ve ameliyat süresi. Bulgular: Gruplarda yer alan hastaların yaş ortalaması benzer idi. Grup 2, Grup 1'e göre anlamlı olarak daha uzun ameliyat süresine ve daha yüksek kan transfüzyonu oranına sahipti. Ortalama hemoglobina değerleri her iki grupta benzerdi. Grup 2'de pertrokanterik femur kırıkları, femur boyun kırıklarından daha yaygındı. Travma ve ameliyat arasındaki süre, ölüm oranı, revizyon cerrahisi, hastanede kalış süresi, yatış maliyet ve ek kırık açısından iki grup arasında anlamlı bir fark yoktu. Sonuç: 75 yaş veya üzeri Dorr tip B femur morfolojisine sahip kalça kırığı olan hastalar çimentolu bipolar hemiartroplasti planlanıyorsa ameliyat öncesi mutlaka eritrosit süspansiyonu hazırlığı yapılmalıdır.

Keywords

Hemiartroplasti Kalça Kalça Kırıkları Yaşlı

References

  • Anderson, L. D., Hamsa JR, W. R., & Waring, T. L. (1964). Femoral-head prostheses: A review of three hundred and fifty-six operations and their results. J Bone Joint Surg Am., 46(5), 1049-1065.
  • Barenius, B., Inngul, C., Alagic, Z., & Enocson, A. (2018). A randomized controlled trial of cemented versus cementless arthroplasty in patients with a displaced femoral neck fracture: a four-year follow-up. Bone Joint J, 100(8), 1087-1093.
  • DeCarlo, L. T. (1997). On the meaning and use of kurtosis. Psychol Methods, 2(3), 292.
  • Dorr, L. D., Faugere, M.-C., Mackel, A. M., Gruen, T. A., Bognar, B., & Malluche, H. H. (1993). Structural and cellular assessment of bone quality of proximal femur. Bone, 14(3), 231-242.
  • Fan, L., Dang, X., & Wang, K. (2012). Comparison between bipolar hemiarthroplasty and total hip arthroplasty for unstable intertrochanteric fractures in elderly osteoporotic patients. PLoS One, 7(6), e39531.
  • Frenken, M., Schotanus, M., van Haaren, E., & Hendrickx, R. (2018a). Cemented versus uncemented hemiarthroplasty of the hip in patients with a femoral neck fracture: a comparison of two modern stem design implants. Eur J Orthop Surg Traumatol., 28(7), 1305-1312.
  • Frenken, M., Schotanus, M., Van Haaren, E., & Hendrickx, R. (2018b). Cemented versus uncemented hemiarthroplasty of the hip in patients with a femoral neck fracture: a comparison of two modern stem design implants. Eur J Orthop Surg Traumatol., 28(7), 1305-1312.
  • Groeneveld, R. A., & Meeden, G. (1984). Measuring skewness and kurtosis. J. R. Stat. Soc., Ser. D Stat. (Online), 33(4), 391-399.
  • Guyen, O. (2019). Hemiarthroplasty or total hip arthroplasty in recent femoral neck fractures? Orthop Traumatol Surg Res., 105(1), S95-S101.
  • Haentjens, P., Autier, P., Barette, M., & Boonen, S. (2001). The economic cost of hip fractures among elderly women: a one-year, prospective, observational cohort study with matched-pair analysis. J Bone Joint Surg Am., 83(4), 493.
  • Holt, E., Evans, R., Hindley, C., & Metcalfe, J. (1994). 1000 femoral neck fractures: the effect of pre-injury mobility and surgical experience on outcome. Injury., 25(2), 91-95.
  • Hopkins, K. D., & Weeks, D. L. (1990). Tests for normality and measures of skewness and kurtosis: Their place in research reporting. Educ Psychol Meas, 50(4), 717-729.
  • Inngul, C., Blomfeldt, R., Ponzer, S., & Enocson, A. (2015). Cemented versus uncemented arthroplasty in patients with a displaced fracture of the femoral neck: a randomised controlled trial. Bone Joint J., 97(11), 1475-1480.
  • Kiran Kumar, G., Meena, S., Kumar, V., Manjunath, S., & Mk, V. R. (2013). Bipolar hemiarthroplasty in unstable intertrochanteric fractures in elderly: a prospective study. J Clin Diagn Res., 7(8), 1669.
  • Lu-Yao, G. L., Keller, R. B., Littenberg, B., & Wennberg, J. E. (1994). Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am, 76, 15-25.
  • Mahomed, N. N., Arndt, D. C., McGrory, B. J., & Harris, W. H. (2001). The Harris hip score: comparison of patient self-report with surgeon assessment. J Arthroplasty., 16(5), 575-580.
  • McKinley, J., & Robinson, C. (2002). Treatment of displaced intracapsular hip fractures with total hip arthroplasty: comparison of primary arthroplasty with early salvage arthroplasty after failed internal fixation. J Bone Joint Surg Am., 84(11), 2010-2015.
  • Melton III, L. J., Crowson, C., & O’fallon, W. (1999). Fracture incidence in Olmsted County, Minnesota: comparison of urban with rural rates and changes in urban rates over time. Osteoporos Int., 9(1), 29-37.
  • Miyamoto, S., Nakamura, J., Iida, S., Shigemura, T., Kishida, S., Abe, I., Takeshita, M., Otsuka, M., Harada, Y., & Orita, S. (2018). The influence of bone cement and American Society of Anesthesiologists (ASA) class on cardiovascular status during bipolar hemiarthroplasty for displaced femoral-neck fracture: A multicenter, prospective, case-control study. Orthop Traumatol Surg Res., 104(5), 687-694.
  • Moors, J. J. A. (1986). The meaning of kurtosis: Darlington reexamined. Am Stat, 40(4), 283-284.
  • Moran, C. G., Wenn, R. T., Sikand, M., & Taylor, A. M. (2005). Early mortality after hip fracture: is delay before surgery important? J Bone Joint Surg Am., 87(3), 483-489.
  • Muirhead-Allwood, W., Hutton, P., & Glasgow, M. (1983). A comparative study of cemented and uncemented Thompson prosthesis. J Bone Joint Surg Br., 65(2), 218-219.
  • Nash, W., & Harris, A. (2014). The Dorr type and cortical thickness index of the proximal femur for predicting peri-operative complications during hemiarthroplasty. J Orthop Surg (Hong Kong). 22(1), 92-95.
  • Ong, B. C., Maurer, S. G., Aharonoff, G. B., Zuckerman, J. D., & Koval, K. J. (2002). Unipolar versus bipolar hemiarthroplasty: functional outcome after femoral neck fracture at a minimum of thirty-six months of follow-up. J Orthop Trauma. , 16(5), 317-322.
  • Parker, M., & Johansen, A. (2006). Hip fracture. Bmj, 333(7557), 27-30.
  • Rogmark, C., Carlsson, Å., Johnell, O., & Sernbo, I. (2003). Costs of internal fixation and arthroplasty for displaced femoral neck fractures. Acta Orthop Scand. , 74(3), 293-298.
  • Sah, A. P., Thornhill, T. S., LeBoff, M. S., & Glowacki, J. (2007). Correlation of plain radiographic indices of the hip with quantitative bone mineral density. Osteoporos Int., 18(8), 1119-1126.
  • Seckin, B. (2003). Kollum Femoris Kırıklarında Unipolar ve Bipolar Parsiyel Protezlerin Karşılaştırılması
  • Singh, M., Nagrath, A. R., & Maini, P. S. (1970). Changes in trabecular pattern of the upper end of the femur as an index of osteoporosis. J Bone Joint Surg Am., 52(3), 457-467.
  • Sonar, U. V., Ingle, M. V., Koichade, M. R., Yelne, A. B., & Malu, N. (2014). Comparative study between trochanteric fixation nailing and cemented bipolar hemiarthroplasty for the treatment of unstable osteoporotic intertrochanteric neck femur fractures in elderly patients. IOSR J Dent Med Sci, 3, 31-40.
  • Weinrauch, P. (2006). Intra-operative error during Austin Moore hemiarthroplasty. J Orthop Surg (Hong Kong). 14(3), 249-252.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Muhammed Çağatay Engin 0000-0002-9302-9587

Serdar Toy 0000-0001-8074-4672

Kemal Zencirli 0000-0003-2702-0266

Mehmet Cenk Turgut 0000-0002-8642-6824

Publication Date October 4, 2022
Submission Date November 28, 2021
Published in Issue Year 2022 Volume: 11 Issue: 3

Cite

APA Engin, M. Ç., Toy, S., Zencirli, K., Turgut, M. C. (2022). Results of Cementless and Cemented Bipolar Hemiarthroplasty in Proximal Femur Fractures with Dorr Type B Morphology. Balıkesir Sağlık Bilimleri Dergisi, 11(3), 361-367. https://doi.org/10.53424/balikesirsbd.1029509
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