ABSTRACT
Purpose: To evaluate the clinical and radiographic results of primary bipolar arthroplasty during average 9.8-year period, using a non-cemented Multilock femoral stem and a biarticular acetabular cup. Materials and Methods: This study included 24 patients (29 hips) who underwent primary bipolar hemiarthroplasties with Multilock femoral stems and biarticular cups and who could be followed for more than seven years. Clinically, we evaluated the Harris Hip scores and patient complaints of thigh and inguinal pain. We also evaluated the radiographic measurements around the femoral stems and the bipolar cups. Results: The average Harris Hip score improved from 57.4 points to 91.6 points; and 3 (10.3%) hips were associated with thigh pain and 4 (13.8%) hips with inguinal pain. Around the femoral stem there was a non-progressive radiolucent line less than 1 mm in length in 4 (13.8%) hips and osteolysis was present in 6 (20.6%) hips. With respect to the stability of the fixations, there was osseous ingrowth in 26 (89.7%) hips and fibrous ingrowth in 3 (10.3%) hips. Around the acetabulum there was osteolysis in 5 (17.2%) hips, proximal migration of the cup in 2 (6.9%) hips, and erosion of the acetabular cartilage in 10 (34.5%) hips. There were 3 (10.3%) biarticular cups, which were converted to total hip arthroplasties, but no femoral stems were revised. The overall failure rate of the primary operations was 10.3%. Conclusion: The current study demonstrated favorable results after bipolar hemiarthroplasties with Multilock femoral stems. However, the osteolysis that occurred around the femoral stems and the acetabula emerged as a problem after the total hip arthroplasties. In particular, it is expected that the osteolysis would increase over time and become the main cause for the need for surgical revision.
Subject(s)
Humans , Acetabulum , Arthroplasty , Cartilage , Follow-Up Studies , Hemiarthroplasty , Hip , Osteolysis , Reoperation , ThighABSTRACT
OBJECTIVE: Our purpose was to evaluate the effect of transabdominal cervicoisthmic cerclage before pregnancy among the patients who had poor obstetric outcome from previous failed transvaginal cervical cerclage and/or an anatomically defective cervix. STUDY DESIGN: A retrospective review of pre-conceptional transabdominal cervicoisthmic cerclage patients was conducted at Hanyang University Medical Center from 1989 to 1997, and analysis of the pregnancy outcomes after preconceptional transabdominal cervicoisthmic cerclage operation. RESULTS: The fifteen patients had 11 successful pregnancy outcomes. Two patients had two consecutive succesful pregnancies and repeat cesarean section deliveries after TCIC. CONCLUSION: We conclude that the transabdominal cervicoisthmic cerclage before pregnancy offers a high rate of fetal salvage with a minimal complications in patients with extremely poor obstertric histories as a result of cervical incompetence, where vaginal cerclage is not warranted.