Joint motion of bipolar hemiarthroplasty in routine hip functional movements: a dynamic motion study
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(2020) 21:731
RESEARCH ARTICLE
Open Access
Joint motion of bipolar hemiarthroplasty in routine hip functional movements: a dynamic motion study Weizhou Jiang1†, Jun Xiao1†, Bin Chen1†, Ming Jia2, Yang Zhang1, Jian Wang1 and Zhanjun Shi1*
Abstract Background: Many motion studies have shown that the inner bearing of bipolar prostheses moves less than expected under non-weight-bearing and static weight-bearing positions, which are not routine functional movements performed postoperatively. The aim of this study was to investigate the behaviours of bipolar prostheses during normal gait and simulative squatting. Methods: Thirty-one femoral neck fracture patients were enrolled, and fluoroscopy examinations of walking on a treadmill, simulative squatting, and non-weight-bearing abduction-adduction and flexion-extension motions were performed at an average of 40 months postoperatively. The rate of acetabular cartilage degeneration was calculated. The ranges of motion of the outer bearing and inner bearing were determined, and the O/I ratios were calculated. Clinical efficacy was assessed by HHS and EQ-5D score. Results: The inner bearing moved more than the outer bearing did, with an O/I ratio of 0.81, during the normal gait examination, while the motion of the outer bearing was obviously dominant during the simulative squatting and non-weight-bearing abduction-adduction and flexion-extension examinations. The mean acetabular cartilage degeneration rate was 0.82 ± 0.54 mm/year at the follow-up. In subgroup analyses, the motion of the outer bearing decreased to some extent with the increase in acetabular wear, and the corresponding O/I ratios among the groups showed a trend of decreasing first and then increasing. The HHS and EQ-5D scores of the patients with osteolysis and femoral stem loosening were much worse than those with fixed implants. Conclusion: Bipolar prostheses do function as originally intended during gait, but movement primarily occurs at the outer bearing during other examinations. The motion patterns of bipolar prostheses change with the increase in acetabular wear. Keywords: Bipolar hemiarthroplasty, Motion, Inner bearing, Outer bearing, Treadmill, Osteoarthritis, Femoral neck fractures
Background Bipolar hemiarthroplasty (HA) was initially developed for the treatment of displaced femoral neck fractures in elderly people to reduce the complications of unipolar * Correspondence: [email protected] † Weizhou Jiang, Jun Xiao and Bin Chen contributed equally to this work. 1 Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China Full list of author information is available at the end of the article
HA, such as acetabular erosion and groin pain, which are caused by movement between the hard metal head and the acetabular cartilage [1, 2]. Bipolar prostheses are designed to have two articulations. The inner, low friction bearing is composed of a metal inner head and a polyethylene liner, while the outer bearing is composed of a metal outer head and an acetabulum. Th
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