Interprosthetic Joint Motion in Bipolar Partial Hip Arthroplasty After One-Year Follow-up
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Abstract
Background. Partial hip arthroplasty is the treatment of choice for displaced proximal femoral fractures in the elderly. The bipolar prosthesis was developed to lessen the acetabular erosion encountered with the unipolar prosthesis. However, bipolar prostheses lose their motion between the inner or outer articulation (interprosthetic joint motion) after three months, rendering them biomechanically like unipolar prostheses. Meanwhile, other literature has shown that the interprosthetic joint is mobile radiographically up to one year after the surgery.
Objective. This study evaluated and quantified the interprosthetic joint motion (motion between the outer and inner articulations) of bipolar prostheses one year after partial hip arthroplasty for proximal femoral fractures in a tertiary hospital. We also investigated the effect of adding the hip measurement in adduction.
Methodology. This retrospective cohort study measured the motion of the outer and inner articulations of locally available bipolar prostheses and the interprosthetic joint movement using one-year postoperative radiographs of patients who underwent bipolar partial hip arthroplasty for femoral fractures in a tertiary hospital from 2019 to 2021. Immediate and one-year post-operative AP radiographs in neutral, maximum hip abduction, and maximum hip adduction were measured and compared. The interprosthetic joint motion was calculated from the difference in pelvic-head angles and pelvic-shaft angles.
Results. Twelve patients were included in the study. The interprosthetic joint in bipolar prosthesis was still mobile even after one year in 75% of patients (p = 0.0001). Adding hip adduction measurements resulted in a significantly higher mean of 74.69 degrees as compared to only 34.67 degrees (p = 0.0006).
Conclusion. Most patients retained a mobile interprosthetic joint at one year post-op. Hip adduction radiographs gave additional information on the total interprosthetic joint motion. At both time points studied, the inner head articulation contributed more to the interprosthetic joint motion. All five locally available implant systems used showed good motion after one year.
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