J Korean Hip Soc.  2007 Jun;19(2):71-76. 10.5371/jkhs.2007.19.2.71.

Analysis of Risk Factors Affecting Degeneration of the Acetabular Cartilage after Bipolar Hemiarthroplasty

• Kim JH
• Lee S
• Ko DO
• Park KY
• Jeon YW
• Yang SJ

• KMID: 2064160
• DOI: http://doi.org/10.5371/jkhs.2007.19.2.71

Abstract

PURPOSE
This study attempted to investigate the rate of acetabular cartilage wear, as well as the risk factors that are related to degeneration, for patients who were diagnosed with femur neck or intertrochanteric fracture and who underwent bipolar hemiarthroplasty.
MATERIALS AND METHODS
34 patients who were diagnosed with femur neck or intertrochanteric fracture and who underwent bipolar hemiarthroplasty were selected as the study subjects, and they were followed up for more than 2years. We examined potential relationships between the degeneration of acetabular cartilage and the various risk factors by comparing radiographs taken before and after operations.
RESULTS
After bipolar hemiarthroplasty, the average degenerative change in the acetabular cartilage was 0.20 mm/yr. Specifically, the average appeared significantly different according to gender (p=0.039, Male: 0.26 mm/yr, Female: 0.19 mm/yr), age (p=0.02, the under 70-year olds: 0.29 mm/yr, the upper 70-year olds: 0.13 mm/yr), the life style, (p=0.037, the stand-up life style: 0.18 mm/yr, the sit-down life style: 0.24 mm/yr), (ED note: stand up and sit down made no sense.) and using femoral stem cementing (p=0.237, cement: 0.22 mm/yr, non-cement: 0.21 mm/yr). The bone mineral density score (p=0.254), activity score (p=0.041), HHS (p=0.027) and femoral stem alignment (p=0.438) were shown to be -3.7, 3.2, 87 and varus 1 degree for people with less than average degeneration of the acetabular cartilage and -3.9, 4.3, 75 and varus 2 degrees for people with more than average degeneration of the acetabular cartilage, respectively.
CONCLUSION
The results showed no significant relationship between degeneration of the acetabular cartilage and patient gender, the presence of osteoporosis and using femoral stem cement. The degeneration of acetabular cartilage was faster for young patients, for patients with a sit-down life style, for a higher activity score or for a lower HHS. It is strongly recommended for surgeons to consider the patients' various conditions such as age, activity and a sit-down lifestyle when deciding between hemiarthroplasty and total hip arthroplasty.

Keyword

Hip joint; Acetabular cartilage; Femur fracture; Bipolar hemiarthroplasty

MeSH Terms

Acetabulum*
Aged
Arthroplasty, Replacement, Hip
Bone Density
Cartilage*
Female
Femur Neck
Hemiarthroplasty*
Hip Joint
Humans
Life Style
Male
Osteoporosis
Risk Factors*