Superiority of fixed stem bipolar prosthesis over Austin Moore prosthetic in fracture neck femur

Authors

  • Mohd Abdul Naser Department of Orthopedics, Indian Institute of Medical Science and Research, Badnapur, Jalna, Maharashtra, India
  • Ritesh Pathak Department of Orthopedics, Indian Institute of Medical Science and Research, Badnapur, Jalna, Maharashtra, India
  • Ather Ahmad Department of Orthopedics, Indian Institute of Medical Science and Research, Badnapur, Jalna, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20182415

Keywords:

Austin Moore’s prosthesis, Fixed stem bipolar prosthesis, Hemiarthroplasty, Femoral neck fracture

Abstract

Background: Hemi arthroplastyis a better option in treatment of fracture neck femur as it eliminates avascular necrosis of femoral head and non-union. It allows immediate weight bearing to return elderly patients to activity which helps in avoiding complications of recumbency and inactivity. The decision to perform hemi arthroplasty using a unipolar or bipolar prosthesis is a controversial issue. Both the prosthesis can be used even in remote areas both are cost effectives, good results can be achieved by general orthopaedic surgeons and post-operatively, it can be well adapted by Indian population. This study was done to compare the efficiency of Austin Moore’s prosthesis (AMP) and bipolar prosthesis for the management of intra capsular fracture neck femur in elderly patients.

Methods: Patient’s above 60 years with fracture neck of femur were included. In all total 140 patients were randomly allocated for treatment by either AMP or bipolar prosthesis, in the department of Orthopaedics, IIMSR Medical College, Badnapur, Jalna between March 2014 to March 2017. The patients were followed up at 6 weeks, 12 weeks, 6 months and 1year. Functional outcome was assessed and compared with modified Harris hip score.

Results: Modified Harris hip score was better with bipolar group as compared to AMP group. Functional activities like use of public transport were better with bipolar group. Complications like acetabular erosion were rare in bipolar group as comparison to AMP group.

Conclusions: Fixed stem bipolar prosthesis is a superior option as compared to Austin Moore’s prosthesis.

References

Campbell‘s Operative Orthopaedics 11th edition. Hip Fractues. 2007: 3274.

Rockwood CA, Green DP, Bucholz RW, Heckman JD. Fractures in Adults. Philadelphia.

Sandhu HS. Management of fracture neck of femur. Indian J Orthop. 2005;39:130-36.

Butler M, Norton R, Lee-Joe T, Cheng A, Campbell AJ. The risk of hip fracture in older people from private homes and institutions. Age ageing. 1996;25:381-85.

Hinton RY, Smith GS. The association of age, race, and sex with the location of proximal femoral fractures in the elderly. J Bone Joint Surg. 2003;75:752-9.

Ingalhalikar VT, ShekarKumta. Fracture neck femur anatomical and biomechanical aspects. Clinc. Orthop India. 1987.

Seth MK (Col). Stress fractures of the neck of femur. Clinical Orthropaedics India. 1987;1:105-09.

Devas M, Hinves B. Prevention of acetabular erosion after hemiarthroplasty for fractured neck of femur. J Bone Joint Surg Br. 1983:65:548-51.

James SE, Gallannaugh SC. Bi-articular hemiarthroplasty of the hip: a 7 year follow-up. Injury. 1991;22:391-93.

Cornell CN, Levine D, O‘Doherty J, Lyden J. Unipolar Versus bipolar hemiarthroplasty for the treatmentoffemoral neck fractures in the elderly. Clin Orthop Relat Res. 2008;348:67-71.

Lestrange NR. Bipolar arthroplasty for 496 hip fractures. ClinOrthop. 1990;251:7-19.

Davison JN, Calder SJ, Anderson GH, Ward G, Jagger C, Harper WM, Gregg PJ. Treatment for displaced intracapsular fracture of the proximal femur. A prospective, randomised trial in patients aged 65 to 79 years. J Bone Joint Surg Br. 2001;83:206-12.

Calder SJ, Anderson GH, Jagger C, Harper WM, Gregg PJ. Unipolar or bipolar prosthesis for displaced intracapsular hip fracture in octogenarians: a randomised prospective study. J Bone Joint Surg Br. 1996;78:391-4.

Lance Ford EM. Use of Moore self lockingVitallium prosthesis in acute fractures of the femoral neck. JBJS. 1965;47:832-41.

Bhushan Sabnis M, Ivan Brenkel J. Unipolar versus bipolar uncemented hemiarthroplasty for elderly patients with displaced intracapsular femoral neck fractures. J Orthop Surg. 2011;19(1):8-12.

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Published

2018-06-23

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Original Research Articles