European Journal of Molecular & Clinical Medicine

Background: To assess the short term clinical and radiological outcomes of Indian Uncemented Bipolar Hemiarthroplasty.
Materials & methods: A total of 20 patients were enrolled. Complete demographic and clinical details of all the patients were obtained. Only those patients were enrolled  with  transcervical fracture neck of femur and which were scheduled to undergo bipolar hemiarthroplasty. Clinical outcome was assessed by Harris Hip Score. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software.
Results:Mean blood loss during surgery was 193.2 millilitres. Mean Harris hip score at baseline, 3 weeks follow-up, 6 weeks follow-up, three months follow-up and one year follow-up was 42.3, 59.8, 69.1, 78.3, and 84.8 respectively. Significant results were obtained while comparing the mean Harris hip score at different time intervals. Excellent outcome was seen in 35 percent of the patient while good outcome was seen in 40 percent of the patients.
Conclusion: Hemiarthroplasty using Uncemented Bipolar prosthesis for fractures of the femoral neck in satisfactory outcome and more rapid return to unassisted activity.

Fracture neck of femur is a leading cause of hospital admissions in elderly age group. The number of such admissions is on a rise because of increased longevity, osteoporosis and sedentary habits. Conservative methods of treatment is not acceptable because it results in nonunion with unstable hip and limitation of hip movement as well as complications of prolonged immobilization like bed sores, deep vein thrombosis and respiratory infections. The present study was a prospective study of 20 cases of fracture neck of femur admitted to hospital. Cases were selected according to inclusion and exclusion criteria i.e., patients with intra-capsular fracture neck of femur above the age of 50yrs. Medically unfit and patients not willing for surgery were excluded from the study. At the final one year follow up assessment with Harris Hip Score 6 patients (30%) achieved 'Excellent' result, 9 patients (45%) achieved 'Good' result, 2 patients (10%) achieved 'fair' result and 3 patients (15%) achieved 'poor' result. Overall, 75% of the patients achieved an excellent or good result. On enquiry regarding the overall satisfaction with the procedure and return to pre-fracture levels of activity, 8 patients (35%) were 'very satisfied', 12 (50%) were 'fairly satisfied' and 2 (15%) were 'not satisfied'.

Introduction: Hemiarthroplasty is a common treatment for patient with a fragility displaced femoral neck fracture. The surgical approach used for hemiarthroplasty is expected to affect the treatment outcomes, in terms of dislocations, performance in daily activities, quality of life after the procedure and the learning curve for surgeons. However, little is known about how the approaches influences the functional outcome following hemi arthroplasty. We hypothesized that both approaches would give comparable results.
 
Aim : To assess the overall functional outcome in patients undergoing hemi replacement hip arthroplasty using Moore’s approach and modified Hardinge approach.
Material and methods: In a prospective interventional study between January 2020 to June 2021 which included 43 hips with a displaced Fracture Neck of Femur at RajaRajeswari medical college and hospital, Bangalore. Sample size was calculated using formula n=Z²*(SD)²/L². Subjects were assigned to treatment groups using simple random sampling technique. Intra-operative and immediate post-operative parameters was entered in MS EXCEL spread sheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 22.0. The student’s t-test was used for normally distributed data and the Mann-Whitney U test for ordinal data. The chi-squared test or Fisher’s exact test were used for nominal data. Patients were followed up for a duration of 6months post-operatively. Functional outcome was assessed by Harris Hip Score (HHS).
Results: The mean age was 70.46 years and 31 (72.09%) patients had left sided hip involvement. Mean operating time was significantly more in the Modified Hardinge’s group (112 minutes) compared to the Moore’s group (91.30minutes). Length of incision and amount of blood loss was significantly high in Moore’s approach (p <0.001). Two patients (8.6%) had posterior dislocation of hip postoperative and one patient (4.3 %) had superficial surgical site infection in Moore’s group. Mean Harris Hip score at 6weeks (65.42 ± 5.70, 70.68 ± 4.81, p value <0.03) and 3 months (71.21 ± 5.57, 76.35 ± 5.25, p value <0.004) follow-up was significantly higher in Modified Hardinge’s Group and 6 months (84.31 ± 6.19, 85.9 ± 2.55, p value >0.05) did not show any significant difference between the two groups.
 
Conclusion: Adopting the Modified Hardinge’s approach instead of the posterior approach in hip hemi arthroplasty for femoral neck fracture patients could lower the rate of complications

An elderly male presenting to theOrthopaedics OPD with complaints of pain and swelling over left shoulder for 2 days with a history of trauma. Radiological investigations were done and suggestive of Left proximal humerus fracture with multiple displaced fragments with Acromioclavicular joint arthropathy¹. After extensive planning, he was operated on with left hemiarthroplasty. Post-op regular follow up undertaken and post-op rehabilitation under expert guidance

Background: Fracture of the intracapsular femur neck is a commonly reported fracture in the Department of Orthopedics. The management of the intracapsular femur neck fracture using cemented bipolar hemiarthroplasty has yielded good outcomes in elderly subjects.
Aim: The present study was conducted to evaluate functional outcomes following management of intracapsular femur neck fracture using cemented bipolar hemiarthroplasty.
Materials & Methods: The present prospective clinical study was conducted on 28 subjects diagnosed with an intracapsular femur neck fracture. After management, the results were assessed and categorized as: Poor, fair, good, and excellent based on the Harris Hip Score.
Results: On assessing the Harris Hip scores grading in the study subjects, it was seen that poor scores were seen in 10.71% (n=3) subjects, the Harris hip scores were fair in 25% (n=7) study subjects, the good scores were noted in 50% (n=14) study subjects, and the excellent scores were seen in 14.28% (n=4) study subjects. Concerning the radiological parameters in the study subjects, it was seen that radiological gradings were excellent, good, and poor in 50% (n=14), 39.28% (n=11), and 10.71% (n=3) study subjects respectively. The ectopic eruption was present in 17.85% (n=5) of study subjects and was absent in 882. 14% (n=23) study subjects. Neck shaft angle was >140^o in 46.42% (n=13) study subjects and was 110⁰-140^o in 53.57% (n=15) study subjects. Femoral anteversion was 15±5⁰ in 46.42% (n=13) study subjects, <10⁰ in 21.42% (n=6) study subjects, and was >20^o in 32.14% (n=9) study subjects.
Conclusion: The present study concluded that one of the best ways for managing intracapsular femur neck fracture is cemented bipolar arthroplasty which shows good clinical outcomes in elderly subjects. To assess the complications continuous radiological and clinical testing is vital.