Abstract
It has been stated in the literature that a bipolar hemiarthroplasty has a lower risk of dislocation compared to a unipolar hemiarthroplasty. As this statement has not been substantiated we undertook a systematic review of the literature of published articles from the last 40 years. In addition we used our own database of hip fractures. One hundred and thirty-three published articles were included in the review to give a total of 23,107 cases. The overall dislocation rate for all types of hemiarthroplasty was 791/23,107 (3.4%). An increased risk of dislocation was associated with a posterior surgical approach and the use of a cemented prosthesis. After adjustment for surgical approach and the use of cement there was no difference in risk of dislocation between unipolar and bipolar hemiarthroplasties. There was an increased risk of open reduction for a bipolar hemiarthroplasty.
Résumé
Il a été affirmé dans la littérature qu’une hémiarthroplastie bipolaire à un risque inférieur de luxation comparé à une hémiarthroplastie unipolaire. Comme cette déclaration n’a pas été établie nous avons entrepris une révision systématique de la littérature pour étudier les articles publiés au cours des 40 dernières années. De plus nous avons utilisé notre propre base de données de fractures de la hanche. 133 articles publiés ont été inclus dans la révision pour donner un total de 23107 cas. Le taux global de luxations pour tous les types d’hémiarthroplastie était 791/23107 (3.4%). Un risque augmenté de luxation a été associé avec un abord chirurgical postérieur et l’usage d’une prothèse cimentée. Après ajustement pour l’abord chirurgical et l’usage de ciment il n’y avait aucune différence dans le risque de luxation entre hémiarthroplasties unipolaires et bipolaires. Il y avait un risque augmenté de nécessité de réduction ouverte pour les luxations d’hémiarthroplasties bipolaires.
Similar content being viewed by others
References
Calder SJ, Anderson GH, Jagger C et al (1996) Unipolar or bipolar prosthesis for displaced intracapsular hip fracture in octogenarians: a randomised prospective trail. J Bone Joint Surg Br 78:391–394
Chan RN-W, Hoskinson J (1975) Thompson prosthesis for fractured neck of femur. A comparison of surgical approaches. J Bone Joint Surg Br 57:437–443
Cornell CN, Levine D, Odoherty J, Lyden J (1998) Unipolar versus bipolar hemiarthroplasty for the treatment of femoral neck fractures in the elderly. Clin Orthop 348:67–71
Davison JN, Calder SJ, Anderson GH et al (2001) Treatment for displaced intracapsular fracture of the proximal femur: a prospective, randomised trial in patients aged 65–79 years. J Bone Joint Surg Br 83:206–212
D’Ambrosia RD, Chuinard RG, D’Amico DM et al (1975) An analysis of dislocation of the cemented femoral hemiarthroplasty. Surg Gynecol Obstet 141:534–538
Iorio R, Healy WL, Lemos DW et al (2001) Displaced femoral neck fractures in the elderly; outcomes and cost effectiveness. Clin Orthop 383:229–242
Keene GS, Parker MJ (1993) Hemiarthroplasty of the hip—the anterior or posterior approach? A comparison of surgical approaches. Injury 24:611–613
Malhotra R, Arya R, Bhan S (1995) Bipolar hemiarthroplasty in femoral neck fractures. Arch Orthop Trauma Surg 114:79–82
Parker MJ, Rajan D (2001) Arthroplasties (with and without bone cement) for proximal femoral fractures in adults (Cochrane review). In: The Cochrane Library, Issue 3. Update Software, Oxford
Sikorski JM, Barrington R (1981) Internal fixation versus hemiarthroplasty for the displaced subcapital fracture of the femur. J Bone Joint Surg Br 63:357–361
Wood MR (1980) Femoral head replacement following fracture: an analysis of the surgical approach. Injury 11:317–320
Yassin M, Velan GJ, Garti A et al (2002) Bipolar hip prosthesis in the treatment of displace sub-capital fracture of the femur. J Bone Joint Surg Br 83(Suppl 3):298
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Varley, J., Parker, M.J. Stability of hip hemiarthroplasties. International Orthopaedics (SICOT) 28, 274–277 (2004). https://doi.org/10.1007/s00264-004-0572-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-004-0572-z