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Large diameter metal on metal total hip replacement for femoral neck fractures with neurological conditions: A retrospective assessment.

Li J, Zheng W, Zhao J, Liu D, Xu W - Indian J Orthop (2014)

Bottom Line: At the latest followup, all the patients showed satisfactory clinical and radiographic results, with pain relief.No complications, such as dislocation or aseptic loosening occurred.We believe the use of L-MoM can diminish the rate of instability or dislocation, after operation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China.

ABSTRACT

Background: Patients with Parkinson's disease and poliomyelitis can have a femoral neck fracture; yet, the optimal methods of treatment for these hips remains controversial. Many constrained or semi-constrained prostheses, using constrained liners (CLs) with a locking mechanism to capture the femoral head, were used to treat femoral neck fractures in patients with neurological disorders. We retrospectively studied a group of patients with Parkinson's disease and poliomyelitis who sustained femoral neck fractures and were treated by total hip arthroplasty using an L-MoM prosthesis.

Materials and methods: We retrospectively reviewed 12 hips in 12 patients who underwent large-diameter metal-on-metal (L-MoM) total hip replacement between May 2007 and October 2009. Eight of the 12 patients (8 hips; 66.7%) had Parkinson's disease and 4 patients (4 hips; 33.3%) were affected with poliomyelitis.

Results: The followup time was 5.2 years (range 3.6-6.0 years). At the latest followup, all the patients showed satisfactory clinical and radiographic results, with pain relief. No complications, such as dislocation or aseptic loosening occurred.

Conclusion: We believe the use of L-MoM can diminish the rate of instability or dislocation, after operation. The L-MoM is an option for patients with Parkinson's disease and poliomyelitis with femoral neck fracture.

No MeSH data available.


Related in: MedlinePlus

(a) Radiograph of the pelvis with both hip joints anteroposterior view showing left femoral neck fracture (Garden grade IV). (b) The attempted lateral radiograph of the left hip showing fracture of the femoral neck. (c) Radiograph five years after surgery, the acetabular and femoral prosthesis were fixed in place and no lucencies were detected. (d) Clinical photograph showing that she could sit down on common seat
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Figure 2: (a) Radiograph of the pelvis with both hip joints anteroposterior view showing left femoral neck fracture (Garden grade IV). (b) The attempted lateral radiograph of the left hip showing fracture of the femoral neck. (c) Radiograph five years after surgery, the acetabular and femoral prosthesis were fixed in place and no lucencies were detected. (d) Clinical photograph showing that she could sit down on common seat

Mentions: At the final followup evaluation, 1 of the 12 hips (8.3%) had Brooker I heterotopic ossification. All prostheses were fixed in place and no instances of frank loosening were noted. No patients were found to have continuous radiolucent lines, although in some patients with stable hips, there were 1 to 2 mm peripheral radiolucent lines, usually at the superolateral portion of the acetabular component bone interface. There was no evidence of migration of any acetabular or femoral component [Figures 1 and 2].


Large diameter metal on metal total hip replacement for femoral neck fractures with neurological conditions: A retrospective assessment.

Li J, Zheng W, Zhao J, Liu D, Xu W - Indian J Orthop (2014)

(a) Radiograph of the pelvis with both hip joints anteroposterior view showing left femoral neck fracture (Garden grade IV). (b) The attempted lateral radiograph of the left hip showing fracture of the femoral neck. (c) Radiograph five years after surgery, the acetabular and femoral prosthesis were fixed in place and no lucencies were detected. (d) Clinical photograph showing that she could sit down on common seat
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4232831&req=5

Figure 2: (a) Radiograph of the pelvis with both hip joints anteroposterior view showing left femoral neck fracture (Garden grade IV). (b) The attempted lateral radiograph of the left hip showing fracture of the femoral neck. (c) Radiograph five years after surgery, the acetabular and femoral prosthesis were fixed in place and no lucencies were detected. (d) Clinical photograph showing that she could sit down on common seat
Mentions: At the final followup evaluation, 1 of the 12 hips (8.3%) had Brooker I heterotopic ossification. All prostheses were fixed in place and no instances of frank loosening were noted. No patients were found to have continuous radiolucent lines, although in some patients with stable hips, there were 1 to 2 mm peripheral radiolucent lines, usually at the superolateral portion of the acetabular component bone interface. There was no evidence of migration of any acetabular or femoral component [Figures 1 and 2].

Bottom Line: At the latest followup, all the patients showed satisfactory clinical and radiographic results, with pain relief.No complications, such as dislocation or aseptic loosening occurred.We believe the use of L-MoM can diminish the rate of instability or dislocation, after operation.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai, China.

ABSTRACT

Background: Patients with Parkinson's disease and poliomyelitis can have a femoral neck fracture; yet, the optimal methods of treatment for these hips remains controversial. Many constrained or semi-constrained prostheses, using constrained liners (CLs) with a locking mechanism to capture the femoral head, were used to treat femoral neck fractures in patients with neurological disorders. We retrospectively studied a group of patients with Parkinson's disease and poliomyelitis who sustained femoral neck fractures and were treated by total hip arthroplasty using an L-MoM prosthesis.

Materials and methods: We retrospectively reviewed 12 hips in 12 patients who underwent large-diameter metal-on-metal (L-MoM) total hip replacement between May 2007 and October 2009. Eight of the 12 patients (8 hips; 66.7%) had Parkinson's disease and 4 patients (4 hips; 33.3%) were affected with poliomyelitis.

Results: The followup time was 5.2 years (range 3.6-6.0 years). At the latest followup, all the patients showed satisfactory clinical and radiographic results, with pain relief. No complications, such as dislocation or aseptic loosening occurred.

Conclusion: We believe the use of L-MoM can diminish the rate of instability or dislocation, after operation. The L-MoM is an option for patients with Parkinson's disease and poliomyelitis with femoral neck fracture.

No MeSH data available.


Related in: MedlinePlus