Use of Lampang Cement Gun for Unipolar Hemiarthroplasty In Elderly Patients With Femoral Neck Fracture
Article Sidebar
Main Article Content
Abstract
Background : Cemented unipolar hemiarthroplasty is the common treatment of femoral neck fracture in elderly patients. The authors had invented Lampang cement gun (LCG) from a caulking gun to improve cementing technique. There was no previous study about LCG in clinical use.
Objective : To evaluate the clinical result of using LCG for cemented unipolar hemiarthroplasty in elderly patients with fresh femoral neck fracture.
Material and method : A retrospective study was conducted on elderly patients who underwent cemented unipolar hemiarthroplasty (46 Austin Moore, 13 Thompson) in Lampang Hospital between October 2003 and January 2008. The femoral canal was occluded with bone plug, then was filled with cement by using LCG. Clinical outcome was assessed by Harris hip score (HHS). Radiographic quality of cement interdigitation was evaluated by modified Barrack’s score.
Results : There were 15 men and 44 women with the mean age of 78 years (range, 65-96). Eighteen patients died and two were lost to follow-up. Thirty-nine patients enrolled the study. The mean follow-up period was 36 months (range, 11-63). The mean HHS was 81.9 (range, 52-93). Excellent result was found in 15.4%, good 51.3%, fair 28.2% and poor in 5.1% of the patients. Dislocation and infection rate were 7.7% and 2.6% respectively. One patient had periprosthetic fracture and subsequent loosening. The mortality rate at 3, 6 and 12 months were 6.7%, 13.3% and 20% respectively.
Conclusion : The clinical result of using LCG for cemented unipolar hemiarthroplasty in elderly patients with femoral neck fracture was acceptable and safe. LCG could be used to improve cementing technique and save operative cost
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
References
Phadungkiat S, Chiengthong K, Chariyalertsak S, Suriyawongpaisal P, Rajatanavin R, Woratanarat P. Incidence of hip fracture in Chiang Mai. J Med Assoc Thai 2002; 85:565-71.
Rojanasthien S, Luevitoonvechkij S. Epidemiology of hip fracture in Chiang Mai. J Med Assoc Thai 2005; 88(Sppl 5):S105-9.
Woratanarat P, Wajanavisit W, Lertbusayanukul C, Loahacharoensombat W, Ongphiphatanakul B. Cost analysis of osteoporotic hip fractures. J Med Assoc Thai 2005; 88 (Sppl 5):S96-104.
Khan RJ, MacDowell A, Crossman P, Datta A, Jallali N, Arch BN, Keene GS. Cemented or uncemented hemiarthroplasty for displaced intracapsular femoral neck fractures. Int Orthop 2002; 26(4):229-32.
Barrack RL, Mulroy RD, Harris WH. Improved cementing technique and femoral component loosening in young patients with hip arthroplasty : a 12-year radiographic review. J Bone Joint Surg Br 1992; 74:385-9.
Mulroy RD Jr, Harris WH. The effect of improved cementing techniques on component loosening in total hip replacement an 11-year radiographic review. J Bone Joint Surg Br 1990; 72 :757-60.
Roberts DW, Poss R, Kelly K. Radiographic comparison of cementing techniques in total hip arthroplasty. J Arthroplasty 1986; 1:241-7.
Oh I, Harris WH. A cement fixation system for total hip arthroplasty. Clin Orthop Relat Res 1982; (164):221-9.
Russotti GM, Coventry AB, Stauffer RN. Cemented total hip arthroplasty with contemporary techniques: a five-year minimum follow-up study. Clin Orthop Relat Res 1988; (235):141-7.
อนุวัตร พงษ์คุณากร. การประดิษฐ์ชุดปืนฉีดซีเมนต์ยึดกระดูก อย่างง่ายและประหยัด (Simplified invention technique of bone cement injection gun). ลำปางเวชสาร 2549 ; 27:51-5.
Pongkunakorn A, Pengkong N, Maneeratroj W. Comparison of caulking gun and standard cement gun using for femoral cementation. J Med Assoc Thai 2008; 91(1):62-7.
Stavrakis T, Lyras D , Kremidas N, HardouVelis C, Dermon A. Hemiarthroplasty for fractures of the neck of the femur : a comparative study. EEXOT 2008; 59(1):63-6.
Harris W. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg Am 1969; 51:737-55.
Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979; (141):17-27.
Sonne-Holm S, Walter S, Jensen JS. Moore hemi-arthroplasty with and without bone cement in femoral neck fractures. A clinical controlled trial. Acta Orthop Scand 1982; 53(6):953-6.
Dorr LD, Glousman R, Hoy AL, Vanis R, Chandler R. Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty. J Arthroplasty 1986; 1:21–8.
Parker MJ, Gurusamy KS. Arthroplasties (with and without bone cement) for proximal femoral fractures in adults (review). The Cochrane Library 2008; issue 4.
Anderson GH, Dias JJ, Hoskinson J, Harper WM. A randomized study of the use of bone cement with Thompson’s prosthesis in the treatment of intracapsular fractures of the femoral neck. J Bone Joint Surg 1992; 74(Sppl 2):132–3.
Lennox IA, McLauchlan J. Comparing the mortality and morbidity of cemented and uncemented hemiarthroplasties.
Injury 1993;24(3):185-6.
Faraj AA, Branfoot T. Cemented versus uncemented Thompson’s prostheses: a functional outcome study. Injury 1999; 30(10):671-5.
Pryor GA. A study of the influence of technical adequacy on the clinical result of Moore hemiarthroplasty. Injury 1990; 21:361-5.
Meere PA, DiCesare PE, Zuckerman JD. Hip fractures treated by arthroplasty. In : Callaghan JJ, Rosenberg AG, Rubash HE, editors. The adult hip. Philadelphia : Lippincott-Raven; 1998. p1221-40.
Christie J, Robinson CM, Singer B, Ray DC. Medullary lavage reduces embolic phenomena and Ahmad I. Mortality and morbidity in elderly patients with fracture neck of femur treated by hemiarthroplasty. J Coll Physicians Surg Pak 2006; 16(10):655-8.
Sharif KM, Parker MJ. Austin Moore hemiarthroplasty: technical aspects and their effects on outcome, in patients with fractures of the neck of femur. Injury 2002; 33(5):419-22.
Tellisi N, Wahab KH. Re-operations following Austin Moore hemiarthroplasty: a district hospital experience. Injury 2001; 32(6):465-7.
Dhar D. Early results of Austin Moore prosthesis in elderly patients with fracture neck femur.
J Orthopaedics 2007 [cited 2009 Jan 01) 4(1)e3. Available from URL: http://www.jortho.org/ 2007/4/1/e3
Nather A, Seow CS, Iau P, Chan A. Morbidity and mortality for elderly patients with fractured neck of femur treated by hemiarthroplasty. Injury 1995; 26(3):187-90.
กระทรวงสาธารณสุข กรมการแพทย์ สำนักพัฒนาวิชาการแพทย์. แนวทางเวชปฏิบัติเรื่องโรคกระดูกพรุน. นนทบุรี : โรงพิมพ์ชุมนุมสหกรณ์การเกษตรแห่งประเทศไทย จำกัด, 2548:1-30.
Meyer S. Prosthetic replacement in hip fractures: a comparison between the Moore and Christiansen endoprostheses. Clin Orthop Relat Res 1981; (160):57-62.
Wachtl SW, Jakob RP, Gautier E. Ten-year patient and prosthesis survival after unipolar hip hemiarthroplasty in female patients over 70 years old. J Arthroplasty 2003; 18(5):587-91.
Biscevic’ M, Smrke D, Gavrankapetanovic’ I. Possibilities of unipolar hip hemiarthroplasty after femoral neck fracture. Med Arh 2005; 59(3):179-82.
Clayer M, Bruckner J. The outcome of Austin-Moore hemiarthroplasty for fracture of the femoral neck. Am J Orthop 1997; 26(10):681-4.
Nottage WM, McMaster WC. Comparison of bipolar implants with fixed-neck prostheses in femoralneck fractures. Clin Orthop Relat Res 1990; (251):38-43.
Montgomery SP, Lawson LR. Primary Thompson prosthesis for acute femoral neck fractures. Clin Orthop Relat Res 1978; (137):62-8.
d’Aubigne’ RM, Pastel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone