scholarly journals Long stem total arthroplasty and bipolar hemiarthroplasty using wagner prosthesis with hardinge approach

2020 ◽  
Vol 11 (6) ◽  
Keyword(s):  
Bipolar Hemiarthroplasty ◽  
Total Arthroplasty ◽  
Long Stem ◽  
Hardinge Approach

Bipolar Hemiarthroplasty vs Total Arthroplasty of the Patients with Aseptic Necrosis of the Femoral Head - 20 year retrospective study

2018 ◽  
Vol 69 (1) ◽  
pp. 96-100
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Carmen Greierosu ◽  
Victor Grigorescu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Femoral Head ◽  
Bipolar Hemiarthroplasty ◽  
Implant Survival ◽  
Aseptic Necrosis ◽  
Common Cause ◽  
Bipolar Prosthesis ◽  
Total Arthroplasty ◽  
Prosthesis Revision ◽  
Prosthetic Surgery

We evaluated 1541 patients with aseptic necrosis of the femoral head who underwent prosthetic surgery over a period of 20 years and assessed each implant survival rate depending on the surgucal technique used. The patients were divided into two groups. The first group contained patients with stage II and III of aseptic necrosis, while the second group contained patients with coxarthrosis secondary to the aseptic necrosis of the femoral head. In 20 years, the revision of the bipolar prosthesis in patients with NACF stage III was rated at 1.65%, p=0.0005 and the total prosthesis was rated 7.41%, in patients with secondary NACF coxarthrosis, in spite of 3.98% which was in patients with NACF, p=0.002. The cotyloid was the most frequent cause for the bipolar prosthesis revision and the aseptic loosening of the cup was the most common cause for the total prosthesis revision in patients with secondary NACF coxarthrosis.

Cementless Bipolar Hemiarthroplasty Using a Hydroxyapatite-Coated Long Stem for Osteoporotic Unstable Intertrochanteric Fractures

2011 ◽  
Vol 26 (4) ◽  
pp. 626-632 ◽  
Author(s):  
Young-Kyun Lee ◽  
Yong-Chan Ha ◽  
Byeong-Keun Chang ◽  
Ki-Choul Kim ◽  
Tae-young Kim ◽  
...  
Keyword(s):  
Bipolar Hemiarthroplasty ◽  
Intertrochanteric Fractures ◽  
Long Stem

scholarly journals A PROSPECTIVE STUDY OF COMPLICATIONS IN BIPOLAR HEMIARTHROPLASTY USING MODIFIED HARDINGE APPROACH IN THE MANAGEMENT OF FEMORAL NECK FRACTURES

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Mukka Naveen ◽  
N. Srinivas Reddy
Keyword(s):  
Femoral Neck ◽  
Functional Outcomes ◽  
Hip Dislocation ◽  
Femoral Neck Fractures ◽  
Surgical Approaches ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Geriatric Population ◽  
Neck Fracture ◽  
Hardinge Approach

Introduction: Fracture of femoral neck is on the rise in the recent years owing to the increase in the geriatric population, severe osteoporosis and increased brittleness of the bone with advancing age. Total hip replacement was mostly used in the initial days but owing to higher chances of dislocations, it is less preferred. Bipolar hemiarthroplasty has become one of the main methods of treatment. A variety of surgical approaches have been used. Posterior approach is the most preferred approach currently, followed by Hardinge approach. Complications like dislocation, infection and abductor lurch are still common with current approaches. This study was undertaken to show the functional outcomes of a Modified Hardinge approach which seems to have optimal results out of all the approaches. Aim: To evaluate the functional outcomes and complications of modified hardinge approach. Materials and Methods: A total of 20 patients with fracture neck of femur were taken into the study and treated with Bipolar Hemiarthroplasty using modified Hardinge approach between June 2018 and October 2019. Each patient was put through the same preoperative and postoperative protocols. They was screened for comorbidities and were taken up for surgery. Complications after this approach were evaluated post operatively for a period of 6 months. Results: The mean hip score was 80. Complications like posterior hip dislocation and infection were nil. Abductor lurch was not noted in any of the patients. One patient had infection out of 20 which was managed accordingly. Conclusion: Bipolar hemiarthroplasty through modified Hardinge approach can be used in the management of femoral neck fractures with lowest complication rate. Complications like posterior dislocation and abductor lurch were nil in the study. The only downside of the procedure being a longer learning curve makes it a less used approach compared to others. Keywords: Hemiarthroplasty, modified Hardinge approach, femoral neck fracture

scholarly journals The surgical management of metastatic lesions of the femur

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Aaron K Saini ◽  
Nando Ferreira
Keyword(s):  
Femoral Neck ◽  
Intramedullary Nailing ◽  
Pathological Fracture ◽  
Bone Tumour ◽  
Bipolar Hemiarthroplasty ◽  
Prophylactic Measure ◽  
Intramedullary Device ◽  
Total Arthroplasty ◽  
Cemented Arthroplasty ◽  
Femoral Metastasis

ABSTRACT BACKGROUND: Malignant tumours commonly metastasise to bone. When this occurs in the femur, surgical intervention is required to reduce pain and restore mobility post fracture, or as a prophylactic measure when fracture is anticipated. This is typically in the form of replacement with hemi- or total arthroplasty or stabilisation with an intramedullary device. The indications for one modality over the other are debatable and the reported outcomes and complications are varied. The purpose of this study is to assess the management algorithm for bony metastasis of the femur at a tertiary bone tumour unit, and the outcomes of the surgical strategies employed METHODS: A retrospective cohort study was performed of all patients presenting to our institution with femoral metastasis, both with and without pathological fracture, who were managed surgically from April 2016 to February 2020. Fractures of the femoral neck were managed with cemented arthroplasty. All other fractures were managed with intramedullary nailing, as were all lesions requiring prophylactic stabilisation. Data was recorded regarding demographics, primary pathology, location of lesion, type of surgery, and implant used. The incidence of complications including radiological failure of fixation, infection, thromboembolic phenomena, re-operation and mortality were recorded RESULTS: Eighty-five femurs in 77 patients were included (mean age 61 years, range 20-90). Lesions were located in the femoral neck (19/85, 22%), intertrochanteric (20/85, 24%), subtrochanteric (40/85, 47%), diaphyseal (2/85, 2%) and metaphyseal/per-condylar (4/85, 5%) regions of the femur. A total of 64/85 (753%) procedures were performed for fractures and 21/85 (25%) prophylactically. Eighteen of the 85 (21%) underwent long-stemmed cemented bipolar hemiarthroplasty, 1/85 (1%) long-stemmed cemented total hip replacement (THR), 62/85 (73%) cephalomedullary nailing, and 4/85 (5%) retrograde femoral intramedullary nailing. Mean follow-up was eight months (range 1-36). There were no dislocations or periprosthetic fractures in the arthroplasty group. One failure (1/66, 2%) of fixation occurred in the intramedullary nailing group. Six deaths occurred in the arthroplasty group (6/64, 9%) and 24 in the nailing group (24/66, 36%) during the study period. Four patients suffered from thromboembolic phenomena (4/77, 5%). Of the 13 patients who sustained a pathological fracture and were managed with intramedullary nailing and followed up for at least one year, all had achieved clinical and radiological union CONCLUSION: Femoral metastasis can be appropriately managed with intramedullary nailing, both prophylac-tically and in the event of fracture, with a low rate of implant failure and an expectation that healing will occur once stabilised. Intracapsular fractures can be managed with long-stemmed cemented arthroplasty with a low risk of subsequent fracture or dislocation Level of evidence: Level 4 Keywords: bone metastasis, femur, pathological fracture

Epidemiological Study of Femoral Head Osteonecrosis

2017 ◽  
Vol 68 (5) ◽  
pp. 974-976
Author(s):  
Alexandru Patrascu ◽  
Liliana Savin ◽  
Dan Mihailescu ◽  
Victor Grigorescu ◽  
carmen Grierosu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Head Group ◽  
Bipolar Hemiarthroplasty ◽  
Aseptic Necrosis ◽  
Total Hip ◽  
Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

Use of tranexamic acid is not associated with complications following bipolar hemiarthroplasty for metastatic disease

2020 ◽  
Author(s):  
Aaron Owen ◽  
Elizabeth P. Wellings ◽  
Cody C. Wyles ◽  
Brandon J. Yuan ◽  
Peter S. Rose ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Metastatic Disease ◽  
Bipolar Hemiarthroplasty

scholarly journals Patterns of Cell Division and the Risk of Cancer

Genetics ◽  
2003 ◽  
Vol 163 (4) ◽  
pp. 1527-1532 ◽  
Author(s):  
Steven A Frank ◽  
Yoh Iwasa ◽  
Martin A Nowak
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Basal Layer ◽  
Mutation Rates ◽  
Tissue Architecture ◽  
Cell Lineages ◽  
Cell Mutation ◽  
Long Stem ◽  
Risk Of Cancer ◽  
Transit Cell

Abstract Epidermal and intestinal tissues divide throughout life to replace lost surface cells. These renewing tissues have long-lived basal stem cell lineages that divide many times, each division producing one stem cell and one transit cell. The transit cell divides a limited number of times, producing cells that move up from the basal layer and eventually slough off from the surface. If mutation rates are the same in stem and transit divisions, we show that minimal cancer risk is obtained by using the fewest possible stem divisions subject to the constraints imposed by the need to renew the tissue. In this case, stem cells are a necessary risk imposed by the constraints of tissue architecture. Cairns suggested that stem cells may have lower mutation rates than transit cells do. We develop a mathematical model to study the consequences of different stem and transit mutation rates. Our model shows that stem cell mutation rates two or three orders of magnitude less than transit mutation rates may favor relatively more stem divisions and fewer transit divisions, perhaps explaining how renewing tissues allocate cell divisions between long stem and short transit lineages.

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