الفهرس | Only 14 pages are availabe for public view |
Abstract Hemiarthroplasty, either unipolar or bipolar, has been advocated for a variety of hip problems. Long-term problems associated with hemiarthroplasty include acetabular articular cartilage degeneration (generally experienced as either groin or buttock pain), femoral loosening and subsidence causing thigh pain with the typical “startup” pain, Dislocation, breakage of implant leading to loss of function, peri-prosthetic fracture and prosthetic infection. Hemiarthroplasty of the hip is short lived in active patients and cannot be considered as bone preserving procedure as high rate of acetabular and femoral deficiencies was found in spite of short period after the primary hip surgery. Conversion from failed hemiarthroplasty to total hip arthroplasty was associated with many intraoperative problems such as acetabular and femoral defects, intraoperative periprothetic fracture and difficulties related to removal of the primary implants and cement. Conversion surgery may associate with postoperative complications as postoperative infection and dislocation. Conversion arthroplasty found to be an excellent treatment strategy for symptomatic failed hemiarthroplasty in terms of pain relief and restoration of function and mobility as near as possible to the pre-injury level. In this study it was noticed that: Groin pain was the main presenting symptom for most of the patients and the cause of this pain was either acetabular and/or femoral side. Summary and Conclusions 146 Articular cartilage degeneration, acetabular defects and protrusion and loosening of the component was the most common cause of conversion. Loss of bone stack in both acetabular and femoral sides is high with hemiarthroplasty. There is no difference in the functional outcome of bipolar hemiarthroplasty and Monoblock hemiarthroplasty (Thompson and Austin Moore). The most common post-operative complication was dislocation. Functional outcome improved after the conversion surgery Hemiarthroplasty gives poor results in physically active patients, even in elderly individuals and should not be recommended as bone preserving procedure. If hemiarthroplasty is to be performed, Austin- Moore prosthesis should be avoided. |