Among these procedures, hemiarthroplasty has become the most preferred treatment option for surgeons according to the surveys. Unipolar or bipolar hemiarthroplasty in the treatment of. Sep 04, 2008 patients 70 years or older presenting to our hospital with an acute femoral neck fracture are eligible for inclusion. The cemented unipolar prosthesis for the management of displaced femoral neck fractures in the dependent osteopenic elderly. Displaced intracapsular hip fractures are typically treated with hemiarthroplasty ha or total hip arthroplasty tha.
Hemiarthroplasty ha is an effective procedure for treatment of femoral neck fracture. Maletic advises that taking the time to gather and interpret complete patient, family, and treatment histories, heteroanamnesis, and temps scores 6 remains the best strategy for clinicians to differentiate bipolar disorder from unipolar depression. In a previous oneyear followup of an rct from our department including 120 patients randomised to uni or bipolar ha, the bipolar group. Comparison of bipolar hemiarthroplasty and total hip. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the most elderly patients with displaced femoral neck fractures. Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis.
It has been noted that patients undergoing hemiarthroplasty for fracture of. Hemiarthroplasty ha has been a mainstay treatment for displaced femoral neck fractures for many years. Hip dislocation after modular unipolar hemiarthroplasty christopher c. No difference between bipolarunipolar hemiarthroplasty in. Bipolar hemiarthroplasty offers greater range of motion and less acetabular erosion than unipolar hemiarthroplasty. Hemiunibipol the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty uh remains controversial. Hemiarthroplasty for displaced femoral neck fractures in. We hypothesised that selection criteria for unipolar or bipolar prostheses could be constructed based on factors affecting mortality.
A number of professional bodies recommend considering tha for patients that were independently mobile and cognitively intact before injury. Unipolar or bipolar hemiarthroplasty in the treatment of displaced femoral neck fractures. Unipolar versus bipolar hemiarthroplasty 7 subjects and methods the present study is of intracapsular fracture neck of femur in elderly patients above the age of 60 years, irrespective of gender, treated with hemiarthroplasty using uncemented unipolar austin moores prosthesis amp in 20 patients and. The hip coxofemoral joint is a large and stable diarthroidal ballandsocket joint formed by the articulation between the femoral head and the. Hi everyone, i am 32 years male pakistan has broken my left femur neck in road accident which lost blood supply and femur neck dead. The primary aim of this study was to analyse the outcome regarding hip function and hrqol after a displaced femoral neck fracture in the most. Unipolar versus bipolar hip hemiarthroplasty in the. Hemiarthroplasty definition at, a free online dictionary with pronunciation, synonyms and translation. Letter to the editor regarding unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures. We searched databases including pubmed central, medline from 1966, embase from 1980 and the cochrane central register of controlled trials database. Unipolar versus bipolar uncemented hemiarthroplasty for elderly patients with displaced intracapsular femoral neck fractures. Pdf unipolar versus bipolar uncemented hemiarthroplasty. Shoulder hemiarthroplasty physical therapy protocol phase i.
In bipolar surgery, the structure of the prosthesis that replaces the natural femoral head is in two partstherefore, the label bipolar is applied. Major or longterm minor depression without highs is considered unipolar depression by default. It has been noted that patients undergoing hemiarthroplasty for fracture of the hip can indeed experience compromised. Hip hemiarthroplasty bipolar orthopedic associates of. The aim of this study was to compare the outcomes between ha and tha for independently mobile older adults with hip fractures. Mar 16, 2018 hemiarthroplasty ha is an effective procedure for treatment of femoral neck fracture. Unipolar versus bipolar uncemented modular hemiarthroplasty. Bipolar disorder is characterized by cyclic depressive as well as manic or hypomanic episodes, but the depressive phase of the bipolar disorder appears identical to unipolar depression.
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. Electrosurgery makes use of highfrequency electrical current to cut, coagulate, desiccate, and fulgurate tissue and can be performed using either monopolar or bipolar energy in conjunction with a specialized instrument. Total hip arthroplasty versus hemiarthroplasty for. Fractures of neck of femur are common fractures in the elderly. The purpose of this study was to compare the causes of failure and longevity in both types of ha. However, it has recently been reported that bipolar ha bha also provides good outcomes, and it is not clear as to whether bha or tha is most appropriate. In a total hip replacement the socket is also replaced.
There is a lacking evidence to bolster the choice between unipolar or bipolar hemiarthroplasty, let alone the modularity of modern components. The femoral head can be replaced two 2 different ways, either as unipolar or bipolar. Jun 01, 2019 its easy to be confused over the differences between unipolar depression and bipolar disorder depression as they often look so similar. Hip replacement surgery can be performed as a total replacement or a hemi half replacement. However, it is debatable whether unipolar or bipolar ha is the most suitable implant. A metaanalysis chen jiangtao1, zhou yijun2, xun chuanhui1, huo jianjun3, song xinghua1, tian zheng1, akbar yunus1, cao li1 1orthopaedic department, the first affiliated hospital of xinjiang medical university, urumqi 2orthopaedic department, the first peoples. Hemi means half, and arthroplasty means joint replacement. The bipolar head is also larger than the single, conventional unipolar prosthetic head, which means. Patients and methods 28 ambulatory, lucid patients were randomized to treatment with a unipolar or a bipolar hemiarthroplasty for an acute.
To the best of our knowledge, this is the first rct that systematically analyses acetabular erosion after unipolar ha and bipolar ha using a modern hemiarthroplasty with identical stems in both groups. Investigators aimed to quantitatively compare the clinical efficacy and complications of both types of hemiarthroplasty. Hemiarthroplasty is a common procedure in the treatment of femoral neck fractures in the elderly. A person may start of being happy and then go quickly to becoming sad or depressed. Hemiarthroplasties in young patients with osteonecrosis or. Conclusion based on the results of this study, there does not appear to be any advantage to the use of a bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly. A systematic literature search up to april, 2014 was conducted to include rcts comparing bh with uh. The decision to perform hemiarthroplasty using a unipolar or bipolar prosthesis remains controversial, with proponents on either side. Inngul c, hedbeck cj, blomfeldt r, lapidus g, ponzer s, enocson a. Is there a significant difference in surgery and outcomes. How does unipolar depression differ from bipolar depression. The purpose of this study was to report the conversion rate of ha to total hip arthroplasty tha for displaced femoral neck fractures and compare outcomes between implant constructs bipolar vs unipolar, fixation options cemented vs cementless stems, and age groups bipolar hip conversion coding errors. Another advantage of this design would be increased range of motion compared to unipolar implants. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoralneck fractures.
Unipolarbipolar measurement range data acquisition. Monopolar electrocautery monopolar electrosurgery can be used for several modalities including cut, blend, desiccation, and fulguration. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the. In this lesson, we will explore the difference between bipolar and unipolar depression and the symptoms of each. Incontrast,datafromourowninstitutionon 830 exeter has displayed no difference in reoperation rate between unipolar or bipolar has 6. The operation is similar to a total hip replacement but it involves only half of the hip. Unipolar vs bipolar hemiarthroplasty dennis zw ng and kevin bl lee 198 materials and methods all patients who underwent hemiarthroplasty for displaced neck of femur fractures between 1 january 2004 and 31 december 2007 were analysed from a log of all operative procedures.
Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures. In a unipolar hemiarthroplasty only the prosthetic femoral head articulates in the acetabulum, only one point of movement uni 1 in a bipolar hemiarthroplasty there are two points of movement bi 2. Bipolar or unipolar hemiarthroplasty after femoral neck. Bipolar versus fixedhead hip arthroplasty for femoral. Pdf unipolar versus bipolar hemiarthroplasty for displaced.
Until researchers develop more advanced diagnostic procedures, dr. A potential disadvantage of the bipolar implants is the risk of. In a unipolar hemiarthroplasty only the prosthetic femoral head articulates in the acetabulum, only one point of movement uni 1 in a bipolar hemiarthroplasty there are. Higher cartilage wear in unipolar than bipolar hemiarthroplasties of.
Journal of orthopaedic surgery and research, jan 2015. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in. Using a pencil instrument, the active electrode is placed in the entry site and can be used to cut tissue. Proposed advantages of the bipolar prosthesis include less acetabular wear and potentially less hipgroin pain. Despite stark statistics outlining the consequences of misdiagnosis, differentiating unipolar depression from bipolar disorder can be challenging. To keep up an imperative distance from the poor results of internal fixation and early ambulation of patients, hemiarthroplasty is performed. Someone with unipolar depression doesnt go through the highs of bipolar depression. Nov 11, 2015 inngul c, hedbeck cj, blomfeldt r, lapidus g, ponzer s, enocson a. Hemiarthroplasty of the hip physical therapy in seattle. Bipolar cemented hip hemiarthroplasty in patients with femoral neck fracture who are on hemodialysis is associated with risk of stem migration.
Furthermore, the extra cost of bipolar endoprostheses does not seem. Unipolar vs bipolar hemiarthroplastydennis zw ng and kevin bl lee 198 materials and methods all patients who underwent hemiarthroplasty for displaced neck of femur fractures between 1 january 2004 and 31 december 2007 were analysed from a log of all operative procedures. Proposed advantages of the bipolar prosthesis include. Pdf hemiarthroplasty ha is generally considered to be the treatment of choice in the most elderly patients.
This prospective randomized trial compared the efficacy of unipolar versus bipolar hemiarthroplasty in elderly patients or 65 years with displaced femoral neck fractures in terms of quality. The main difference between these modalities is the pathway of the current. Monopolar versus bipolar electrosurgery can be performed using either a monopolar or a bipolar instrument. No significant differences were found between the unipolar and bipolar groups. Bipolar unipolar lower cost simpler bipolar theoretical less wear more modular more expensive. One group receives a unipolar hemiarthroplasty and 15 receives a bipolar arthroplasty. This surgical procedure replaces the head of a damaged femur with an implant designed to stabilize the femur and restore hip function. Unipolar prostheses has a onepiece design where the hip movement occurs between the prosthesis and the acetabulum hip socket. Letter to the editor regarding unipolar versus bipolar. How to differentiate bipolar disorder from unipolar. Such joint replacement orthopaedic surgery is generally conducted to relieve arthritis pain or in some hip fractures. Performing a hemiarthroplasty rather than a total hip arthroplasty in our defined patient population may put the patient at a higher risk for morbidity and future complications.
The primary aim of this study was to analyse the outcome regarding hip function and healthrelated quality of life hrqol in patients randomised to. Patients 70 years or older presenting to our hospital with an acute femoral neck fracture are eligible for inclusion. If you or someone you know is experiencing these symptoms, its important to visit your counseling center or a mental health professional to get the right diagnosis and treatment. Hemiarthroplasty and total hip arthroplasty for treating primary. Factors that could play a role in decisionmaking include patient age, activity level, and associated medical conditions. The purpose of this study is to evaluate the clinical and radiographic outcomes of cementless bipolar hemiarthroplasty with a proximally coated stem in patients. Has, the trend has been that less bipolar and more unipolar hasareused5. In a previous oneyear followup of an rct from our department including 120. Hip dislocation after modular unipolar hemiarthroplasty. Tha ambulatory patients 60 years of age 37% fixation failure avnnonunion. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty.
A hemiarthroplasty is an operation that is used most commonly to treat a fractured hip. Untreated basotrochanteric fracture of one month duration. Ninh, md, anil sethi, md,y mohammed hatahet, md, clifford les, phd, massimo morandi, md, and rahul vaidya, md, frcscy abstract. Bipolar hemiarthroplasty in elderly patients presenting with. Tantalum markers are placed around the acetabulum during surgery. Hemiarthroplasty total hip arthroplasty treatment algorithm femoral neck fracture hip arthroplasty. 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. Cementless bipolar hemiarthroplasty for displaced femoral neck. Hip hemiarthroplasty unipolar versus bipolar hip hemiarthroplasty in the treatment of femoral neck fractures in the elderly ali a.
Jan 24, 2015 whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty uh remains controversial. Aug 28, 2015 displaced femoral neck fractures fnfs in healthy elderly patients have traditionally been managed with hemiarthroplasty ha or total hip arthroplasty tha, with studies suggesting that tha may be the better option. The difference between unipolar and bipolar depression is defined by the symptoms of unipolar depression. Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures. A bipolar hemiarthroplasty design has been used for the treatment of femoral neck fractures for more than 30 years. Tight fit bipolar hip arthroplasty in avn hip in young adults by baldev dudani.
Below is a closer look at the symptoms of both depression and mania. The proposed advantages of using the bipolar design rather than the conventional fixedhead designs for femoral neck fracture in elderly patients are still controversial 8, 9. Differences between unipolar depression and bipolar. Pdf background whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has. A bipolar signal is one that ranges from some negative value to some positive value is both positive and negative going. Only prospective randomized controlled trials rcts. However, there is inadequate evidence to support the choice between unipolar ha or bipolar ha.
Hemiarthroplasty unipolar and bipolar indications approach and procedure moderator. Bipolar disorder is a condition in which people experience extensive mood swings. Pdf unipolar hemiarthroplasty versus bipolar hemiarthroplasty in. Unipolar depression is a mental disorder that results in a patient having episodes of lowmood, low selfesteem, loss of interest, loss of pleasure in enjoyable activities. I would like to confirm some things regarding precautions and lifetime of implant. Although the diagnosis is more complex than that, it does serve as a starting point. Feb 08, 2011 the secondary aim was to analyse the degree of acetabular erosion and its influence upon outcome.
A systematic literature search up to april, 2014 was conducted to include rcts comparing bh with uh for. What are the differences between bipolar and unipolar cautery. Unipolar or bipolar hemiarthroplasty for femoral neck. Unipolar or bipolar hemiarthroplasty in the treatment of displaced. Hemiarthroplasty precautions for bipolar hip hemiarthoplasty. Shoulder hemiarthroplasty physical therapy protocol. Unipolar ha and bipolar ha appeared to produce equivalent clinical outcomes after one year, but the. Difference between bipolar and unipolar bipolar vs unipolar. Bipolar hemiarthroplasty in elderly patients presenting. Displaced femoral neck fractures fnfs in healthy elderly patients have traditionally been managed with hemiarthroplasty ha or total hip arthroplasty tha, with studies suggesting that tha may be the better option. 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. Listing a study does not mean it has been evaluated by the u.
Pdf bipolar cemented hip hemiarthroplasty in patients. They share the symptoms of sadness, hopelessness, pessimism, anxiety and sleep problems, but at some point, unipolar depression and bipolar depression go off in very different directions. Mbbs singapore, mrcs edinburgh mrcs edinburgh, mmed. Unipolar versus bipolar hemiarthroplasty for displaced. Findings indicated that there was no statistically significant difference in any of the measured. Hemiarthroplasty for displaced femoral neck fractures in the. Fortyone patients above 60 years of age and an acute displaced fracture of the femoral neck were randomly allocated to treatment by either unipolar or bipolar hemiarthroplasty, in the department of orthopaedics, between september 2009 and october 2012. 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.
Unipolar versus bipolar hemiarthroplasty for displaced femoral neck. We examine outcome studies comparing use of hemiarthroplasty and total hip arthroplasty, unipolar and bipolar hemiarthroplasty, and cemented vs cementless fixation of femoral stems. Immediate motion weeks 0 to 8 goals allow early healing of capsule increase passive range of motion decrease shoulder pain retard muscular atrophy and prevent rotator cuff inhibition brace discontinue use after six to eight weeks unless otherwise advised by dr. The purpose of this study was to report the conversion rate of ha to total hip arthroplasty tha for displaced femoral neck fractures and compare outcomes between implant constructs bipolar vs unipolar, fixation options cemented vs cementless stems, and age groups hemiarthroplasty unipolar versus bipolar hip hemiarthroplasty in the treatment of femoral neck fractures in the elderly ali a. Advantages of the unipolar prosthesis include lower cost and no risk of polyethylene wear debris. Hemiarthroplasty ha is generally considered to be the treatment of choice in the most elderly patients with a displaced fracture of the femoral neck. There are two types of options, including unipolar hemiarthroplasty uh and bipolar hemiarthroplasty bh, when using a hemiarthroplasty. Bipolar hemiarthroplasties articulates at two different levels and, due to this dual bearing, is thought to have less acetabular wear. This article discusses the use of both unipolar and bipolar prostheses for treatment of femoral neck fractures in. Each of these two modalities has specific advantages and understanding the difference between the two can help you understand the differences in how theyre used.
1387 1141 181 497 277 580 660 1556 1391 486 1617 211 203 618 1592 321 339 1012 246 280 1101 885 911 1368 962 1303 194 1314 1445 1448