Introduction device compatibility 2 sleeve offsets 2 overview of implant sizing 4 cup positioning 5 preoperative planning xray templating 6 surgical technique step 1. In a previous oneyear followup of an rct from our department including 120. Unipolar versus bipolar hemiarthroplasty for displaced femoral. Dislocation of a hemiarthroplasty is uncommon and has a reported overall rate of approximately 3. We describe a case of cemented bipolar hemiarthroplasty as a salvage option for failed femoral neck fixation with retained hardware, despite endstage acetabular cartilage degeneration. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the most elderly patients with displaced femoral neck fractures.
The hip coxofemoral joint is a large and stable diarthroidal ballandsocket joint formed by the articulation between the femoral head and the. Hip hemiarthroplasty unipolar orthopedic associates of. Hip replacement is currently one of the most common orthopaedic operations, though patient satisfaction short and longterm varies widely. Dislocation and dissociation of bipolar hip hemiarthroplasty. Advantages of the unipolar prosthesis include lower cost and no risk of polyethylene wear debris. No significant differences were found between the unipolar and bipolar groups. Hemiarthroplasty ha is an effective procedure for treatment of femoral neck fracture. Among the 31 survivors in the bipolar hemiarthroplasty group, acetabu lar wear occurred in three cases, and radiolu cent lines appeared in the proximal femur in four cases, in the distal femoral prosthesis in one case, and in the central area in one case, which were absent in the first postoperative xray.
One group receives a unipolar hemiarthroplasty and 15 receives a bipolar arthroplasty. Tantalum markers are placed around the acetabulum during surgery. Hemiarthroplasty is a common procedure in the treatment of femoral neck fractures in the elderly. Hip replacement using hemiarthroplasty ha is a common surgical procedure in elderly patients with femoral neck fractures. Unipolar versus bipolar hemiarthroplasty for displaced. How to differentiate bipolar disorder from unipolar. Major or longterm minor depression without highs is considered unipolar depression by default.
A bipolar signal is one that ranges from some negative value to some positive value is both positive and negative going. Unipolar versus bipolar hip hemiarthroplasty in the. There are two types of options, including unipolar hemiarthroplasty uh and bipolar hemiarthroplasty bh, when using a hemiarthroplasty. In this paper, the spwm sinusoidal pulse width modulation technique of unipolar and bipolar inverters is presented and. Maletic advises that taking the time to gather and interpret complete patient, family, and treatment histories, heteroanamnesis, and temps scores 6 remains the best strategy for clinicians to differentiate bipolar disorder from unipolar depression. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures. Unipolar and bipolar pwm inverter semantic scholar. Sabnis and brenkel10 reported 14 % unipolar patients walking unaided compared to 54% of bipolar patients walking unaided. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in the. Unipolar versus bipolar hemiarthroplasty for displaced femoral neck fractures. Data from the swedish hip arthroplasty register suggest that there is a higher risk for revision surgery with the bipolar. A metaanalysis chen jiangtao1, zhou yijun2, xun chuanhui1, huo jianjun3, song xinghua1, tian zheng1, akbar yunus1, cao li1 1orthopaedic department, the first affiliated hospital of xinjiang medical university, urumqi 2orthopaedic department, the first peoples. Unlike total hip replacement, in which both the ball of the femur and the hip socket are replaced, in this procedure, only the ball is replaced. If you or someone you know is experiencing these symptoms, its important to visit your counseling center or a mental health professional to get the right diagnosis and treatment.
S unipolar versus bipolar uncemented modular hemiarthroplasty in patients with displaced femoral. Unipolar prostheses has a onepiece design where the hip movement occurs between the prosthesis and the acetabulum hip socket. Bipolar disorder is a condition in which people experience extensive mood swings. Fortyone patients above 60 years of age and an acute displaced fracture of the femoral. On the other hand, others with 4 years experience of bipolar prosthesis found no protrusion2,4. Cemented bipolar hemiarthroplasty in osteoporosis for. The cemented unipolar prosthesis for the management of. However, there is inadequate evidence to support the choice between unipolar or bipolar hemiarthroplasty. The purpose of this study was to compare the causes of failure and longevity in both types of ha. Patients who had unipolar prostheses were comparatively older to those with bipolar prostheses 75. The decision to perform hemiarthroplasty using a unipolar or bipolar prosthesis remains controversial, with proponents on either side. Unipolar versus bipolar hemiarthroplasty malaysian orthopaedic. There are many inverter topologies but output current distortion and efficiency are the two main parameters for the selection of inverters.
Due to the unsatisfactorily high level of uncertainty, this. Hemiarthroplasty half joint replacement hemiarthroplasty involves replacing the femoral head with a prosthesis, while. Although the diagnosis is more complex than that, it does serve as a starting point. A systematic literature search up to april, 2014 was conducted to include rcts comparing bh with uh. This publication is not intended for distribution in the.
Unipolar or bipolar hemiarthroplasty in the treatment of displaced. To assess the clinical outcomes of unipolar versus bipolar hemiarthroplasty for displaced intracapsular femoral neck fractures in older patients and to report whether bipolar implants. Fractures of neck of femur are common fractures in the elderly. Hip replacement using a hemiarthroplasty ha is a common surgical procedure in elderly patients with fractures of the femoral neck. There is a lacking evidence to bolster the choice between unipolar or bipolar hemiarthroplasty, let alone the modularity of modern components. Unipolar versus bipolar exeter hip hemiarthroplasty. Patients 70 years or older presenting to our hospital with an acute femoral neck fracture are eligible for inclusion. Bipolar has a positive and a negative voltage referenced to zero volts. Unipolar depression is a mental disorder that results in a patient having episodes of lowmood, low selfesteem, loss of interest, loss of pleasure in enjoyable activities. To assess the clinical outcomes of unipolar versus bipolar hemiarthroplasty for displaced intracapsular femoral neck fractures in older patients and to report whether bipolar implants yield better longterm functional results.
The primary aim of this study was to analyse the outcome regarding hip function and healthrelated quality of life hrqol in patients randomised to. Bipolar and unipolar voltages and their significance. In 2010, hedbeck et al randomized 120 patients to either unipolar or bipolar hemiarthroplasty and examined acetabular erosion rates at 1 year. Hip dislocation after modular unipolar hemiarthroplasty christopher c. To avoid the poor outcome of internal fixation and for early mobilization, hemiarthroplasty is performed. Inverter is basically an interface between dc source like photovoltaic cell and ac networks. Hip hemiarthroplasty unipolar versus bipolar hip hemiarthroplasty in the treatment of femoral neck fractures in the elderly ali a. Unipolar vs bipolar hemiarthroplastydennis zw ng and kevin bl lee 198 materials and methods all patients who underwent hemiarthroplasty for displaced neck of femur fractures between 1 january 2004 and 31 december 2007 were analysed from a log of all operative procedures. Bipolar results from disturbances in the areas of the brain that regulate mood it involves periods of excitability mania alternating with periods of depression this may affects men and women equally usually appears between ages 15 25 cause unknown it occurs more often in relatives of people with bipolar disorder, if you believe you have bipolar you might want to visit somewhere like. In this study, they observed a clear decrease in acetabular erosion rates in the bipolar group 5% bipolar vs 20% unipolar, p. Hip dislocation after modular unipolar hemiarthroplasty. The aim of this study was to compare the outcome of unipolar with the bipolar prosthesis in geriatric patients. Furthermore, the extra cost of bipolar endoprostheses does not seem. Performing a hemiarthroplasty rather than a total hip arthroplasty in our defined patient population may put the patient at a higher risk for morbidity and future complications.
Using a pencil instrument, the active electrode is placed in the entry site and can be used to cut tissue. The difference between unipolar and bipolar depression is defined by the symptoms of unipolar depression. We compared cartilage wear between bipolar and unipolar. Comparative study in surgical outcome of intracapsular fracture neck of femur in active. It has been noted that patients undergoing hemiarthroplasty for fracture of the hip can indeed experience compromised.
Ninh, md, anil sethi, md,y mohammed hatahet, md, clifford les, phd, massimo morandi, md, and rahul vaidya, md, frcscy abstract. Monopolar electrocautery monopolar electrosurgery can be used for several modalities including cut, blend, desiccation, and fulguration. A unipolar hemiarthroplasty uha articulates between the large. Proposed advantages of the bipolar prosthesis include.
However, it is debatable whether unipolar or bipolar ha is the most suitable implant. What are the differences between bipolar and unipolar. In a unipolar hemiarthroplasty only the prosthetic femoral head articulates in the acetabulum, only one point of movement uni 1 in a bipolar hemiarthroplasty there are two points of movement bi 2. Difference between bipolar and unipolar bipolar vs unipolar. This prospective randomized trial compared the efficacy of unipolar versus bipolar hemiarthroplasty in elderly patients or 65 years with displaced femoral neck fractures in terms of quality. Unipolar versus bipolar hemiarthroplasty for displaced femoral neck. Furthermore, in a longterm study, soreide et al show that protrusion is a complication of unipolar hemiarthroplasty in 54% of cases studied26. The graters, cup trials and actual deltamotion cups are all a full hemisphere of 180. Conclusion based on the results of this study, there does not appear to be any advantage to the use of a bipolar endoprosthesis in the management of displaced femoral neck fractures in the elderly. Unipolar hemiarthroplasty versus bipolar hemiarthroplasty. The height of the trial is less than the height of the implant by 0. Unipolar or bipolar hemiarthroplasty for femoral neck. A hemiarthroplasty procedure results in less surgical time and less blood loss than a thr. Unipolarbipolar measurement range data acquisition.
Probably unipolar voltages are a single voltage referenced to zero volt as ground. However, in 20, they reported the 4year followup for this same. Most logic gate power supplies and signals are unipolar. Mishra ak, chalise pk, shah sb, adhikari v, singh rp. Bipolar hemiarthroplasty, total hip replacement, neglected femoral neck fracture, hip fracture introduction hip fracture is an international public health problem mainly occurring in elderly patients and resulting in a high mortality. This surgical procedure replaces the head of a damaged femur with an implant designed to stabilize the femur and restore hip function.
To keep up an imperative distance from the poor results of internal fixation and early ambulation of patients, hemiarthroplasty is performed. Pdf unipolar hemiarthroplasty versus bipolar hemiarthroplasty in. Among these procedures, hemiarthroplasty has become the most preferred treatment option for surgeons according to the surveys. This publication is not intended for distribution in the usa. Whether bipolar hemiarthroplasty bh for displaced femoral neck fractures has benefit over unipolar hemiarthroplasty uh remains controversial. Journal of orthopaedic surgery and research, jan 2015.
Someone with unipolar depression doesnt go through the highs of bipolar depression. Until researchers develop more advanced diagnostic procedures, dr. Unipolar or bipolar hemiarthroplasty in the treatment of. Rona hu discusses the probabilistic approach to diagnosing unipolar vs. Calcar preparation with the final broach fully seated, remove the broach handle. However, there is inadequate evidence to support the choice between unipolar ha or bipolar ha. Hemiarthroplasty unipolar and bipolar indications approach and procedure moderator. While harjeet et al concluded that unipolar hemiarthroplasty is an efficacious and costeffective treatment option for femoral neck fractures in the elderly, a metaanalysis by luyao reported that 6% to 18% of patients required a second surgery after unipolar hemiarthroplasty 11,20. In this lesson, we will explore the difference between bipolar and unipolar depression and the symptoms of each. Place the calcar reamer over the post of the broach and machine the femoral neck, ensuring alignment to avoid femur fracture. Hip hemiarthroplasty unipolar bipolar hemiarthroplasty of the hip means that only half of the hip joint wil be replaced hemi half partial. Case report a 58yearold man sustained a subtrochantric fracture of his right hip in.
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