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Objective: The aim of this study was to evaluate the clinical and radiographic outcomes of bipolar hemiarthroplasty with cementless stem for the unstable intertrochanteric fracture in octogenarians and to determine the influencing factors associated with subsidence of the stem., Methods: The study included the 143 hips of 139 patients (119 females, 20 males). Mean follow-up period was 3.8 (range: 2.2 to 9.0) years. The displaced lesser trochanteric fragment was reduced anatomically and fixed with 16-gauge stainless steel cerclage wire. Clinical outcomes included Harris Hip Score (HHS), thigh pain, groin pain and walking ability. Radiographic outcomes included stem fixation and stability, osteolysis, heterotopic ossification and subsidence. The stable reduction group was determined when anatomic reduction of posteromedial fragments was achieved with ≤1 mm gap of fragment., Results: Mean HHS was 82 (range: 78 to 99) at the final follow-up. Thirty-one hips (21.7%) experienced thigh pain and 19 (13.3%) groin pain. One hundred and twelve patients (80.6%) regained their pre-injury level of ambulation. All femoral stems showed osseointegration without aseptic loosening and osteolysis. The mean stem subsidence was 3.1±2.4 (range: 0 to 18) mm. The extent of subsidence was significantly higher in patients with unstable reduction. The survival rate was 94.2%., Conclusion: Cementless bipolar hemiarthroplasty appears to be a suitable method for the treatment of intertrochanteric fracture in octogenarians. However, stable fixation of the posteromedial fragment is necessary to avoid stem subsidence.

The purpose of this study is to evaluate results of isolated acetabular revision with ceramic-on-ceramic bearings using a ceramic head with a metal sleeve. A retrospective review of fifty-three hips was performed. The mean patient age was 49.9 years and the mean follow-up period was 5.7 years. The mean modified Harris hip score improved from 47.5, pre-operatively, to 84.7 at the time of last follow-up ( P < 0.001). Two patients reported squeaking of the hip. Three patients experienced loosening cup, necessitating re-revision surgery. There was a significant difference of acetabular bone defect between loose cup group and stable cup group ( P = 0.018). There were no ceramic fractures and no osteolysis. The survival rate of the acetabular cup at the mid-term follow-up was 94.3%. In conclusion, ceramic head with a metal sleeve can be a reliable option for isolated acetabular revision. [ABSTRACT FROM AUTHOR]

Purpose: The purpose was to evaluate the prevalence and location of simultaneous fracture using bone scans in patients with hip fracture and to determine the risk factors associated with simultaneous fracture.Patients and Methods: One hundred eighty two patients with hip fracture were reviewed for this study. Clinical parameters and bone mineral density (BMD) of the lumbar vertebra and femoral neck were investigated. To identify acute simultaneous fracture, a bone scan was performed at 15.4±4.1days after hip fracture. The prevalence and location of simultaneous fracture were evaluated, and multivariate logistic regression analysis was performed to determine the risk factors.Results: Simultaneous fracture was observed in 102 of 182 patients, a prevalence of 56.0%. Rib fracture was the most common type of simultaneous fracture followed by rib with vertebral fracture. The BMD of the lumbar vertebra was significantly lower in patients with simultaneous fracture (p=0.044) and was identified as an independent risk factor (odds ratio: OR 0.05, 95% confidence interval: CI 0.01-0.57).Conclusions: The prevalence of simultaneous fracture was relatively high among patients with hip fracture, and BMD was significantly lower in patients with simultaneous fracture than in patients without it. Surgeons should be aware of the possibility of simultaneous fracture in patients with hip fracture. [ABSTRACT FROM AUTHOR]