J Korean Orthop Assoc.  2008 Oct;43(5):659-663. 10.4055/jkoa.2008.43.5.659.

Polished Tapered Femoral Stem Displacement during the Closed Reduction of a Redislocated CementedBipolar Hemiarthroplasty of the Hip: A Case Report

Affiliations
  • 1Department of Orthopaedic Surgery, Guro Hospital, Korea University College of Medicine, Seoul, Korea. yun8813@paran.com
  • 2Department of Orthopaedic Surgery, Pohang St. Mary's Hospital, Pohang, Korea.

Abstract

Redislocation of bipolar hemiarthroplasty is not a simple complication. When redislocation of bipolar hemiarthroplasty occurs, open reduction must be considered. Displacement of the polished tapered femoral stem could occur through the unwanted traction force during the reduction of the dislocated cemented hip arthroplasty as a complication. We experienced displacement of the polished tapered femoral stem during closed reduction of a redislocated cemented bipolar hemiarthroplasty. We suggest that preoperative analysis for the cause and status of the dislocation is essential and open reduction should be considered if closed reduction is not thought to be suitable for a polished femoral stem.

Keyword

Bipolar hemiarthroplasty; Redislocation; Polished tapered femoral stem; Displacement

MeSH Terms

Arthroplasty
Dislocations
Displacement (Psychology)
Hemiarthroplasty
Hip
Traction

Figure

  • Fig. 1 Preoperative anteroposterior radiograph of both hips of a 72 year old female showed a displaced right femoral neck fracture.

  • Fig. 2 Immediate postoperative radiograph revealed the cemented bipolar hemiarthroplasty with excessive cement filling distal to the tip of the stem.

  • Fig. 3 This radiograph obtained at postoperative 6th day showed dislocation of the bipolar hemiarthroplasty with flexion and adduction of the right hip.

  • Fig. 4 AP radiograph at postoperative 9th day revealed redislocation of the right hip three days after the first dislocation.

  • Fig. 5 This radiograph showed proximal displacement of the femoral stem after the trial of closed reduction.

  • Fig. 6 Intraoperative photograph demonstrated an incarcerated bipolar cup and head between the short exernal rotator muscles.

  • Fig. 7 Postoperative radiograph showed a well reduced femoral stem and bipolar head without fractures in the bone and cement mantle.


Reference

1. Barnes CL, Berry DJ, Sledge CB. Dislocation after bipolar hemiarthroplasty of the hip. J Arthroplasty. 1995. 10:667–669.
Article
2. Bochner RM, Pellicci PM, Lyden JP. Bipolar hemiarthroplasty for fracture of the femoral neck. Clinical review with special emphasis on prosthetic motion. J Bone Joint Surg Am. 1988. 70:1001–1010.
Article
3. Holt MD. Prosthesis displacement as a complication of reduction of a dislocated total hip arthroplasty. J Arthroplasty. 1996. 11:979–980.
Article
4. Krotenberg R, Stitik T, Johnston MV. Incidence of dislocation following hip arthroplasty for patients in the rehabilitation setting. Am J Phys Med Rehabil. 1995. 74:444–447.
Article
5. Oh HC, Yoo JH, Lee YT, et al. Displacement of polished femoral stem during reduction of a dislocated cemented total hip arthroplasty. -A case report-. J Korean Hip Soc. 2007. 19:513–516.
Article
6. Pai VS. Dislocation of a polished femoral stem following a cemented total hip arthroplasty: a report of 2 cases. J Orthop Surg (Hong Kong). 2005. 13:73–75.
Article
7. Ramaniraka NA, Rakotomanana LR, Leyvraz PF. The fixation of the cemented femoral component. effects of stem stiffness, cement thickness and roughness of the cement-bone surface. J Bone Joint Surg Br. 2000. 82:297–303.
8. Sierra RJ, Schleck CD, Cabanela ME. Dislocation of bipolar hemiarthroplasty: rate, contributing factors, and outcome. Clin Orthop Relat Res. 2006. 442:230–238.
9. Staal HM, Heyligers IC, van der Sluijs JA. Stem displacement during reduction of a dislocated cemented total hip arthroplasty with a polished tapered stem. J Arthroplasty. 2000. 15:944–946.
Article
10. Yoon US, Min HJ, Seo JS, Kim YJ, Won JH, Sun SM. Efficancy of the preventive abduction brace in dementia patients after bipolar hemiarthroplasty of the hip. J Korean Hip Soc. 2006. 18:189–193.
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