Cementless Bipolar Hemiarthroplasty of Hip Fracture in Patients on Hemodialysis

Joon-Hwan Lee; Yee-Suk Kim; Kyu-Tae Hwang; Young-Ho Kim

doi:10.5371/hp.2012.24.3.200

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Lee, Kim, Hwang, and Kim: Cementless Bipolar Hemiarthroplasty of Hip Fracture in Patients on Hemodialysis

Original Article

Hip & Pelvis

Hip & Pelvis 2012; 24(3): 200-205.

Published online: 30 September 2012

DOI: https://doi.org/10.5371/hp.2012.24.3.200

Cementless Bipolar Hemiarthroplasty of Hip Fracture in Patients on Hemodialysis

Joon-Hwan Lee, MD, Yee-Suk Kim, MD, Kyu-Tae Hwang, MD, Young-Ho Kim, MD

Department of Orthopedic Surgery, Guri Hospital, College of Medicine, Hanyang University, Guri, Korea.

Address reprint request to Young-Ho Kim, MD. Department of Orthopaedic Surgery, Guri Hospital, College of Medicine, Hanyang University, 249-1 Kyomun-dong, Guri 471-701, Korea. TEL: +82-31-560-2311, FAX: +82-31-557-8781, kimyh1@hanyang.ac.kr

Received 23 July 2012 Revised 24 September 2012 Accepted 24 September 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

This study analyzed the clinical and radiologic results and complications in patients with chronic renal failure who underwent cementless bipolar hemiarthroplasty for treatment of hip fractures.

Materials and Methods

Between January 2003 and February 2010, we performed 36 consecutive cementless bipolar hemiarthroplasty procedures in 35 patients with hip fracture who were on hemodialysis for chronic renal failure. Clinically, postoperative Harris hip score, inguinal and thigh pain, and orthopaedic and medical complications were investigated. Radiologically, we examined bone ingrowth, osteolysis, loosening, and nonunion.

Results

According to the Harris hip score grading system, the average postoperative score was 85.7 and the function before the injury was restored in 29 cases. Postoperatively, four patients experienced mild inguinal pain and four patients experienced mild thigh pain. One patient experienced severe thigh pain. Orthopaedic complications(6 cases, 16.7%) included mild hematoma(3 cases), superficial wound infection(2 cases), and dislocation(1 case). Medical complications(10 cases, 27.8%) included sepsis(5 cases), multiple organ failure due to aggravation of underlying diseases(2 cases), ulcer perforation(2 cases), and aspiration pneumonia(1 case). Five patients had died within one year (mortality, 13.9%). Except for loosening of the femoral stem in one case, bone ingrowth was observed in all cases. None of the patients had osteolysis and nonunion.

Conclusion

Although cementless bipolar hemiarthroplasty was considered as an effective treatment in patients with hip fractureon hemodialysis due to favorable results at midterm follow-up, close attention for the postoperative medical complications due to poor general condition is needed.

Keywords: Hemodialysis, Hip fracture, Cementless bipolar hemiarthroplasty

Figures and Tables

Fig. 1

(A) Preoperative radiograph showed insufficiency fracture of the right femoral neck. (B) Radiograph showed stable fixation after 1 year 3 months using cementless bipolar hemiarthroplasty of the right hip. (C) After 1 year 6 months of operation, loosening of femoral stem had occurred.

Table 1

Patients Demography

Table 2

Overall Incidence of Complications of Patients Undergoing Hemodialysis after Cementless Bipolar Hemiarthroplasty

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