Comparison of Clinical Results between Bipolar Hemiarthroplasty and Compression Hip Screw on Unstable Intertrochanteric Fractures of the Femur in Elderly Patients

PURPOSE: To investigate postoperative incidence of complications and functional results between two groups, primary bipolar hemiarthroplasty and internal fixation with compression hip screw on unstable intertrochanteric fractures of the femur with severe osteoporosis in elderly patients. MATERIALS AND METHODS: 78 cases treated under unstable intertrochanteric fractures of the femur with severe osteoporotic elderly patients from March 1997 to August 2001 who have been followed up for more than a year were evaluated retrospectively between the group of bipolar hemiarthroplasty, 38 cases out of 60 cases and group of compression hip screw, 40 cases out of 59 cases. The incidence of complications and functional ability according to Merle d'Aubigne scale and the mortality rate were compared using student t-test. RESULTS: The means of Merle d'Aubigne scale for the hemiarthroplasty group and the compression hip screw group were at the last follow up, 15.0 and 13.6 respectively. The differences were statistically significant (p=0.04). Bipolar group revealed significant differences in general (18%) and mechanical complications (5%) between two groups (p0.05). CONCLUSION: We consider that primary bipolar hemiarthroplasty would be better method in the treatment of the unstable femoral intertrochanteric fracture with severe osteoporosis but we need much longer follow up.

Patellar Nonresurfacing Versus Patellar Resurfacing in Total Knee Arthroplasty

PURPOSE: To compare the clinical, radiologic results and complications between the patellar non-resur-faced and resurfaced cases in total knee arthroplasty. MATERIALS AND METHODS: From March 1998 to May 2003, the subjects were 37 patellar non-resurfaced and 45 patellar resurfaced cases followed up more than a year among the patients who had total knee arthroplasty in degenerative arthritis. The results were evaluated by the range of motion, Hospital for Spe-cial Surgery (HSS) knee rating score, and Laurin's and Merchant's congruence angle. Student t-test was used in statistical analysis in comparison of both groups. RESULTS: In non-resurfaced group, the range of motion was incrased from 90.6 degree preoperatively to 108.6 degree postoperatively and HSS score from 62.6 to 84.1 respectively, while in resurfaced group, range of motion was increased from 88.2 degree preoperatively to 110.4 degree postoperatively and HSS score from 59.3 to 85.3. There were no significant differences between two groups (p>0.05). There were some patella-asso-ciated complications in each group, and revision due to patella-associated complications were 1 case (3%) and 2 cases (4%) each. So, patella-associated complications and revision rates revealed no significant dif-ferences (p>0.05). CONCLUSION: There is no difference in the clinical results and complications between patella resurfacing and selective non-resurfacing with relatively good cartilage, More follow up is needed for the necessity of revision due to patella-associated complications.

Differences of Meniscal Injuries by Age Groups

PURPOSE: We analyzed and classified the patterns of meniscal injuries by age groups and tried to find the statistical meanings. MATERIALS AND METHODS: We reviewed 217 cases with meniscal injuries of 340 patients who received knee arthroscopy from January 1996 to June 2000. We analyzed the statistical significances of them by age groups and classified injury patterns of site, shape and combined injuries. RESULTS: Medial meniscal injuries, especially in posterior horn, were more common, and degenerative tears have higher incidence in elderly groups. In younger groups, longitudinal and flap tears were more common. More prevalent associated injuries were ACL tears in younger groups and loose bodies in elderly groups. CONCLUSION: In knee arthroscopy, to find out the patterns of meniscal injuries by age groups is important to determine the method of treatment and prognosis.