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Stability of hip hemiarthroplasties
James Varley1, Martyn J Parker
1Peterborough District Hospital, Thorpe Road, Peterborough, PE3 6DA UK. varley_james@hotmail.com
International Orthopaedics
|August 19, 2004
Summary
Bipolar hemiarthroplasty does not show a lower dislocation risk than unipolar hemiarthroplasty. Both implant types have similar dislocation rates when surgical approach and cement use are considered.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Dislocation is a significant complication following hemiarthroplasty.
- Previous literature suggests bipolar hemiarthroplasty may offer a reduced risk of dislocation compared to unipolar hemiarthroplasty.
Purpose of the Study:
- To systematically review the literature and analyze existing data on dislocation rates for unipolar versus bipolar hemiarthroplasties.
- To determine if bipolar hemiarthroplasty indeed has a lower risk of dislocation.
Main Methods:
- Systematic literature review of articles published in the last 40 years.
- Inclusion of data from a proprietary hip fracture database.
- Analysis of 133 articles comprising 23,107 cases.
Main Results:
- Overall dislocation rate for all hemiarthroplasties was 3.4% (791/23,107).
- Posterior surgical approach and cemented prosthesis were associated with increased dislocation risk.
- No significant difference in dislocation risk was found between unipolar and bipolar hemiarthroplasties after adjusting for surgical approach and cement use.
- Bipolar hemiarthroplasty showed an increased risk of requiring open reduction.
Conclusions:
- The purported benefit of lower dislocation risk with bipolar hemiarthroplasty is not substantiated by current evidence.
- Surgical approach and prosthesis fixation method are critical factors influencing dislocation risk.
- Further research may be needed to explore reasons for increased open reduction rates with bipolar devices.