Cementless Bipolar Hemiarthroplasty for Unstable Intertrochanteric Fractures in Elderly Patients

BACKGROUND: Bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients is a viable option that can prevent the complications of an open reduction, such as nonunion and metal failure. This study evaluated the clinicoradiological results of cementless bipolar hemiarthroplasty for unstable intertrochanteric fractures in elderly patients. METHODS: Forty hips were followed for more than 2 years after cementless bipolar hemiarthroplasty using a Porocoat(R) AML Hip System. The mean age was 78.8 years and the mean follow-up period was 40.5 months. The Harris hip score and postoperative hip pain were analyzed clinically. The radiological results were assessed using a range of indices. RESULTS: At the last follow-up, the mean Harris hip score was 80.6 points. There were one case of hip pain and one case of thigh pain. Twenty-four cases (60%) showed no decrease in ambulation capacity postoperatively. Radiologically, there were 23 cases (57.5%) of fixation by bone ingrowth and 17 cases (42.5%) of stable fibrous fixation. There were no cases of osteolysis. Eleven cases (27.5%) of new bone formation were found around the stem. All stems were stable without significant changes in alignment or progressive subsidence. CONCLUSIONS: The short-term results of cementless bipolar hemiarthroplasty in elderly patients with unstable intertrochanteric fractures were satisfactory.

Ceramic on Ceramic Cementless Total Hip Arthroplasty Using a Large Diameter Head / 대한정형외과학회잡지

PURPOSE: The authors evaluated the clinical and radiological results of ceramic on ceramic articulation cementless total hip arthroplasty using a large diameter head. MATERIALS AND METHODS: Seventy-two hips were followed for more than 2 years after ceramic on ceramic articulation cementless total hip arthroplasty using a 36 mm diameter head. The mean patient age was 62 years (range: 50-85), and the mean follow-up period was 35.3 months (range: 25-53). The Harris hip score, the postoperative inguinal pain and the thigh pain were analyzed clinically. The radiological results were assessed using various radiological indices. RESULTS: The mean Harris hip score improved from preoperative 57.5 points to postoperative 94.8 points. The postoperative mean flexion of hip was 109degrees (range: 100degrees-125degrees), external rotation was 42degrees (range: 35degrees-49degrees) and abduction was 35degrees (range: 30degrees-45degrees). There was one case of inguinal pain. Radiologically, all the stems demonstrated stable fixation without progressive subsidence of the stem or significant change in the cup obliquity. A radiolucent line was observed around the stem in 4 cases (5.6%) and around the cup in 2 cases (2.8%). Endosteal new bone formation was observed around the stem in 28 cases (38.9%) and around the cup in 26 cases (36.1%). There was no osteolysis around the stem or the cup. CONCLUSION: The short-term results of ceramic on ceramic cementless total hip arthroplasty using a large diameter head demonstrated satisfactory results.

Cementless Bipolar Hemiarthroplasty for Femoral Neck Fractures in Elderly Patients / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate clinicoradiological outcomes after cementless bipolar hemiarthroplasty in elderly patients with femoral neck fractures. MATERIALS AND METHODS: Eighty hips-all in patients greater than 70 years of age-were followed for more than 2 years after undergoing cementless bipolar hemiarthroplasty with a tapered cementless stem (Lima SPH-C2(R)). The mean age was 76 years, and the mean follow-up period was 37 months. The Harris hip score and postoperative hip pain were analyzed clinically. The radiological results were assessed using various radiological indices. RESULTS: At last follow-up, the mean Harris hip score was 80.2 points. There was one case of significant hip pain. Fifty-five cases (68.7%) showed no decrease in ambulation capacity postoperatively. Radiologically, there were 47 cases (58.7%) of bone ingrowth and 33 cases (41.3%) of stable fibrous fixation. There were no cases of osteolysis, and 30 cases (37.5%) exhibited new bone formation around the stem. All stems were stable without significant alignment change or progressive subsidence. CONCLUSION: Short-term outcomes proved to be satisfactory in elderly patients undergoing cementless bipolar hemiarthroplasty for femoral neck fractures.

Comparison of Superior Labral Anterior Posterior (SLAP) Lesions: Sports versus Non-sports Induced Injury

PURPOSE: This study compared the SLAP lesions caused by a sports-induced injury with those caused by a nonsports-induced injury. MATERIALS AND METHODS: The study was performed on 54 patients who had undergone arthroscopic surgery for a SLAP lesion. There were 21 sports-induced-injury patients (group I) and 36 non-sports-induced injury patients (group II). The mean age of the men was 36 years and that of the women was 48 years. In both groups, the frequency of a concomitant injury and the clinical outcomes at the last follow-up was evaluated using the UCLA score, Rowe score, and the ASES score. RESULTS: According to their injury mechanism, , there were 14 cases (67%) of repeated microtrauma injury in group I and 25 cases (75%) of compression injury type in group II. As a concomitant pathology, there was 11 cases of shoulder instability and 5 cases of a rotator cuff tear in group I, and 23 cases of rotator cuff tears and 14 cases of shoulder instability in group II. At the last follow up, group I showed slightly better clinical satisfaction (P>0.05). CONCLUSION: The possibility of a SLAP lesion accompanying other diseases is high. Therefore, an accurate assessment of concomitant injury lesions before surgery is important for the treatment outcome.