Clinical Results of Hip Arthroplasty Using Medium-Viscosity Bone Cement Injected with Lampang Invented Cement Gun: Comparison between Bipolar Hemiarthroplasty and Total Hip Arthroplasty
Article Sidebar
Main Article Content
Abstract
Background: Cemented hip arthroplasty is usually performed using an injection gun and medium viscosity bone cement. A novel gun (Lampang cement gun for medium viscosity cement, LCG-MV) was developed at 20% of the cost of a commercial gun to accomplish this task.
Objective: To determine the clinical results of cemented hip arthroplasty using LCG-MV in terms of quality of cementation and functional outcome by comparing between bipolar hip hemiarthroplasty (BHA) and hybrid total hip arthroplasty (THA).
Material and method: A retrospective analytical study was conducted among 81 patients who underwent cemented hip arthroplasty in Lampang Hospital from January 2017 - December 2021 using medium-viscosity bone cement and delivery by LCG-MV. The patients were categorized into 2 groups; BHA and hybrid THA. Cementation quality was assessed by radiographic evaluation according to the Barrack grading system. The functional outcome was assessed using Harris Hip Score (HHS) at one-year postoperatively. Comparison between the two groups was evaluated using the t-test and exact probability test.
Results: The mean age of the patients was 77.6 years (SD 12.1, range 26-97). There were 62 cases receiving BHA and 19 cases receiving THA. Most of them were female (87.7%). The mean age of the BHA group was significantly higher than the THA group (81.8 (SD 6.7) vs 63.7 (SD 15.4) years, p<0.001). All cases in the BHA group sustained femoral neck fracture. Among the THA group, 52.6% of cases were diagnosed of secondary osteoarthritis and 42.1% were femoral neck fractures (p<0.001). Most of the hips demonstrated cementation quality in Barrack grade B (66.1% in BHA and 73.7% in THA groups) and grade A (21.0 % in BHA and 21.1% in THA groups, p=0.783). HHS in the THA group was significantly higher than the BHA group (89.1 (SD 6.1) vs 78.6 (SD 7.1), p<0.001). HHS in the excellent and good levels was found in 94.7% of cases in the THA group and 45.2% of cases in the BHA group (p<0.001).
Conclusion: Cemented hip arthroplasty using medium-viscosity bone cement and delivery by LCG-MV provided satisfactory clinical results. Optimal quality of cementation was shown in 87% to 95% of the cases. Most of the patients had HHS in the good to excellent levels. LCG-MV can help reduce expenditure and may be useful in resource-constrained hospitals.
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
Rojanasthien S, Luevitoonvechkij S. Epidemiology of hip fracture in Chiang Mai. J Med Assoc Thai. 2005; 88(Sppl 5):S105-9.
Simpson P, Breusch SJ. Optimal cementing technique- the evidence: cementgun performance matters. In: Breusch SJ, Malchau H, editors. The well-cemented totalhip arthroplasty: theory and practice. Heidelberg: Springer; 2005. p.155-9.
Udomluck P. Efficacy of injectiongun for medium-viscositybonecement: comparison between invented gun and standard commercialgun. Lampang Med J. 2020;41(1):18-29.
Barrack RL, Mulroy RD, Harris WH. Improved cementing technique and femoral component loosening in young patients with hiprthroplasty : a 12-year radiographic review. J Bone Joint Surg Br. 1992; 74:385-9.
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
McGoldrick NP, Fischman D, Nicol GM, Kreviazuk C, Grammatopoulos G, Beaulé PE. Cementing a collarless polished tapered femoral stem through the anterior approach : evaluation of cement mantle quality and component alignment. Bone Joint J. 2021;103-B(7 Suppl B):46-52.
Schuroff AA, Deeke M, Pedroni MA, Lupselo FS, Kunz RE, Lima AM. Radiographic evaluation of cementation technique using polished, conical, triple-tapered femoral stem in hip arthroplasty. Rev Bras Ortop. 2017;52(Suppl 1):40-45.
Nizam I, Alva A, Gogos S. The bikini incision anterior cemented total hip arthroplasty: assessment of radiological and clinical outcomes - a mid-term review. SICOT J. 2021;7:3.
Wang F, Zhang H, Zhang Z, Ma C, Feng X. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis. BMC Musculoskelet Disord. 2015;16:229.
Schmalzried TP, Harris WH. Hybrid total hip replacement. A 6.5-year follow-up study. J Bone Joint Surg Br. 1993;75(4):608-15.