Hemiarthroplasty is indicated for the surgical treatment of subcapital neck fractures that are displaced and at high risk of femoral head avascular. Echo hip fracture surgical technique zimmer biomet. Hip hemiarthroplasty bipolar this surgical procedure replaces the head of a damaged femur with an implant designed to stabilize the femur and restore hip function. Bipolar hemiarthroplasty will also be done as a salvage procedure after failed initial internal fixation. Modular bipolar hemiarthroplasty for fracture neck of. 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. Hemiarthroplasty can be performed with either a unipolar or bipolar endoprosthesis. In a bipolar hemiarthroplasty there are two points of movement bi 2.
Journal of orthopaedics, modular bipolar hemiarthroplasty. Hip hemiarthroplasty bipolar this surgical procedure. 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. Hip hemiarthroplasty has proven to be an effective treatment for displaced femoral neck fractures for more than 50 years, with low incidence rates of infection and dislocation. Fortyone patients above 60 years of age and an acute displaced fracture of the femoral. The choice of surgical procedure for elderly patients with displaced femoral neck fractures remains controversial 14. The operation is similar to a total hip replacement but it involves only half of the hip. Typically indicated patients include the elderly with displaced femoral neck fractures without osteoarthritis and the medically infirm for whom the additional risks of a total hip replacement do not outweigh the. The bipolar prosthesis is supplied in preassembled form, and the ring has to be removed first using the special reduction forceps. Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. Hip hemiarthroplasty bipolar orthopedic associates of. The furlong hemiarthroplasty system jri orthopaedics. One advantage of a bipolar prosthesis is that it can be easily converted to a total hip arthroplasty without replacing the femoral component and with approximately the same complication rates as a revision total hip arthroplasty. Bipolar hemiarthroplasty is one of the common procedures done for fracture neck of femur in elderly.
There may be less of a chance of hip dislocation following a hemiarthroplasty compared to a thr, too. Subsequent procedure for the bipolar prosthesis determine the definitive femoral head diameter with a trial head of size m. This procedure can be technically demanding, and adequate closure of the capsule and soft tissue cannot be emphasized enough. Hemiarthroplasty of the hip is a simplification of the smithpetersen cup arthroplasty in which half of the joint or femoral head is reshaped to fit the vitallium cup. Hip replacement surgery can be performed as a total replacement or a hemi half replacement. Hemiarthroplasty of the hip is a commonly performed procedure for subcapital neck of femur fractures. Unlike total hip replacement, in which both the ball of the hip hemiarthroplasty bipolar orthopedic associates of port huron. Although treatment of displaced intracapsular fracture by prosthetic replacement is a common procedure for elderly patients, the use of total hip arthroplasty tha. Hemiarthroplasty procedure p ercentage % thr health outcomes following hip fracture23,24 0. There are several different options available for the type of device to be used. If the measurement is between two sizes, select the smaller implant. The overall dislocation rate after bipolar hemiarthroplasty is 0. Good postoperative results of hip hemiarthroplasties in patients with below knee amputations have been reported in the past, with a return of the patients to their preoperative level of daily life activity 1, 2.
Lt modifier is appended to indicate the procedure is performed on the left side. A hemiarthroplasty is indicated when the humeral head is deteriorated or fractured but the glenoid surface is intact. These cases include screw protrusion, avascular necrosis, nonunion or refracture. This study aimed to compare bipolar hemiarthroplasty bh vs. Bipolar cemented hip hemiarthroplasty in patients with. Hip hemiarthroplasty an overview sciencedirect topics.
Hemiarthroplasty unipolar and bipolar indications approach and procedure moderator. Pdf we wanted to evaluate the efficacy of bipolar hemiarthroplasty using bergers twoincision surgical technique for patients with muscular weakness. A hemiarthroplasty is an operation that is used most commonly to treat a fractured hip. The furlong cemented hemiarthroplasty stem is a muller type femoral stem that has been devised. The prosthetic head articulates with the native acetabulum hence it is designated as hemi. Hip hemiarthroplasty is a common procedure for the treatment of subcapital femoral fractures. The npr records the diagnoses and surgical procedures icd10, nordic surgical procedure code of all inpatient. Changes in implant choice and surgical technique for. This easy assembly does not affect separation strength because the selfcentering bipolar exhibits superior pullout strength 2180 newtons. This will act as a steri strip and will protect your knee. However, there is inadequate evidence to support the choice between unipolar or bipolar hemiarthroplasty.
A total hip replacement total hip arthroplasty or tha. Hemiarthroplasty is the surgery of choice if the patient has insufficient glenoid bone to support a glenoid component. Radiological assessment of interprosthetic joint movement. Hemiarthroplasty is the replacement of the humeral component and is also known as humeral head replacement hhr. A hemiarthroplasty is a surgical procedure that involves replacing half of the hip joint. During the hemiarthroplasty procedure, the damaged femoral head and. Treatment for femoral neck fractures can be successfully achieved through a bipolar hemiarthroplasty. But, to our knowledge, the use of hip hemiarthroplasty in patients with above knee. The aim of this study was to compare the outcome of unipolar with the bipolar prosthesis in geriatric patients. Physical therapy in seattle for hip surgery hemiarthroplasty. Bipolar or hemiarthroplasty is a surgical procedure which replaces one half of the joint with an artificial surface and leaves the other part in its natural preoperative state. Bipolar hemiarthroplasty is replacement of the femoral head and neck plus an addition of an acetabular cup that is not attached to the pelvis. This is because of a parenthetical note under code 27125 which indicates to report code 27236 for prosthetic implant following fracture of the hip. Physical therapy in hershey for hip surgery hemiarthroplasty.
Cementless bipolar hemiarthroplasty in femoral neck fractures in elderly article pdf available in indian journal of orthopaedics 453. We searched databases including pubmed central, medline from 1966, embase from 1980 and the cochrane central register of controlled trials database. Femoral neck fracture cemented bipolar hemiarthroplasty. The jri bipolar head is pre assembled and available in 1mm. Replacing the entire hip joint is called total hip replacement thr. Please keep this dressing intact and do not remove. This procedure can be technically demanding, and a. A hemiarthroplasty is generally used to treat a fractured hip. Demographics of patients on hemodialysis who underwent bipolar hemiarthroplasty for femoral neck fracture, and of matched controls hemodialysis control. Hemiarthroplasty is a common treatment for femoral neck fractures in the elderly population. The hhs scores were equal at both followups, but there was a trend towards better hrqol in the bipolar ha group at four months, eq5d index score 0. Information and exercises following a hemiarthroplasty of. Discussion this randomised controlled trial aimed to compare the hrqol,functionalandradiologicaloutcomesafter displaced femoral neck fractures in patients treated with a unipolar or a bipolar hemiarthroplasty.
In a total hip replacement the socket is also replaced. Twenty percent of the patients in the unipolar ha group displayed acetabular erosion at the 12month followup. Implant used for all patients life ortho care bipolar prosthesis was used iso 485 certified company. Information and exercises for hemiarthroplasty of the hip, april 2020 1 information and exercises following a hemiarthroplasty of the hip introduction a hemiarthroplasty is a surgical procedure which replaces one half of the hip joint the head of femur whilst leaving the other half intact. 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. Hemi means half and arthroplasty refers to joint replacement.
There were no significant differences between the groups regarding complications. This surgical procedure replaces the head of a damaged femur with an implant designed to stabilize the femur and restore hip function. In bipolar surgery, the structure of the prosthesis that replaces the natural femoral head is in two partstherefore, the label bipolar is applied. Despite extensive research and the publication of several randomized controlled trials rcts comparing hemiarthroplasty and total hip arthroplasty, the question remains regarding whether there is any advantage of replacing a healthy acetabulum with a cup in healthy elderly. Preoperative templating requires at least an anteroposterior ap radiograph of the pelvis and a lateral radiograph of the affected hip.
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. Hemiarthroplasty is a surgical procedure that replaces one half of the hip joint with a prosthetic while leaving the other half intact. A hemiarthroplasty is replacement of half of the hip joint. Pdf cementless bipolar hemiarthroplasty in femoral neck. Inside the main prosthetic femoral head there will be a second smaller ball. Hip hemiarthroplasty is an orthopedic procedure for the treatment of certain femoral neck fractures where the femoral head is removed and replaced. Westover hills orthopaedics 11212 state highway 151 medical plaza ii, suite 250 san antonio, tx 78251 tel 2107039758 fax 2107039759 total hip arthroplasty hemiarthroplasty. Bipolar hemiarthroplasty in elderly patients presenting with. Dislocations can be complicated by the uncoupling or dissociation of the femoral head component from the femoral stem.
Dislocation and dissociation of bipolar hip hemiarthroplasty. Accolade ii femoral stems are intended for cementless use only and are intended for total and hemiarthroplasty procedures. It was used to compare proportions of events occurring in different groups. Hemi means half, and arthroplasty means joint replacement. Bipolar hemireplacement arthroplasty for femoral neck. The hemiarthroplasty replaces only the ball portion of the hip joint, not the socket portion. The main complications are periprosthetic dislocation and infection, which potentially impact morbidity and quality of life and may contribute to mortality. There are several different options available for the type. This hip facture surgical technique is utilized by kevin garvin, m. Unipolar versus bipolar hemiarthroplasty for displaced. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures. Pdf twoincision bipolar hemiarthroplasty for treating femoral. The goal of preoperative planning is to determine the correct stem size, level of the femoral neck cut, and proper head and stem offset combination.
This procedure shortens hospitalization to 10 to 14 days and has been successful in the relief of hip pain and in increasing hip motions. The femoral head is the focus of bipolar hip conversion surgery, a category of partial hip replacement hemiarthroplasty. Bipolar hemiarthroplasty in elderly patients presenting. Bipolar hip hemiarthroplasty in a patient with an above. Corail hip system product rationale and surgical technique depuy synthes. The prosthetic femoral head that articulates in the acetabulum same as unipolar, and a second area of articulation. The general consensus, however, appear to be that cemented bipolar hemiarthroplasty is preferred for intracapsular femoral neck fracture, because it results in lower pain score postoperatively5. At the later followups the incidence of acetabular erosion accelerated in the bipolar. Calcar preparation with the final broach fully seated, remove the broach handle. Hip hemiarthroplasty wound care you should have a clear adherent gauze prineo overlying your surgical scar. There was an increased rate of acetabular erosion among the patients with unipolar hemiarthroplasties at the early followups with a significant difference at 12 months unipolar has 20 % and bipolar has 5 %, p0. Hip bipolar hemiarthroplasty for femoral neck fracture. A hemiarthroplasty procedure results in less surgical time and less blood loss than a thr. Hemiarthroplasty is a surgical procedure that replaces one half of the hip joint with a prosthetic, while leaving the other half intact.
Hip replacement using hemiarthroplasty ha is a common surgical procedure in elderly patients with femoral neck fractures. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty. The main finding of the study was the difference in hrqol in favour of the bipolar patients at 48 months. Dislocation of the hemiarthroplasty is a recognised but uncommon complication. This video describes one of the most commonly done procedures for displaced fractures of femoral neck in elderly. This will be removed at your firstoperative appointment. Place the calcar reamer over the post of the broach and machine the femoral neck, ensuring alignment to avoid femur fracture. Templating included the use of plastic overlay templates supplied by the prosthesis manufacturer.