Comparative study between bipolar and total hip modular prosthesis following proximal femoral resection / Mustafa M. Abdelaziz Gheat ; Supervised Walid Atef Ebeid , Mahmoud Mohamed Abdelkarim , Wessam Gamal Abosena

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopedic Surgery

Background: There is a debate on the use of either bipolar or total hip modular prosthesis. This debate involved two events. First; acetabular erosion reported following bipolar proximal femoral modular prosthesis was low. Second; the rate of dislocation of the total hip reported to be three folds that of the bipolar modular prosthesis.However, Houdek et al, 2016 reported that there was no significant difference regarding dislocation rate between total hip and bipolar proximal femoral modular prosthesis. Also, Drexler et al, 2015 reported a higher acetabular erosion rate following bipolar proximal femoral modular prosthesis, 13.8% of patients had protrusioacetabuli, and 4.6% had mild degenerative changes. Objectives: To compare between bipolar and total hip modular prosthesis regarding functions, dislocation rate, plus detection of rate of acetabular erosion for a bipolar modular prosthesis in patients who underwent wide resection, and reconstruction by proximal femoral modular prosthesis for primary bone tumours Methods: A retrospective and prospective comparative cohort study was done on patients who underwent wide resection, and reconstruction by proximal femoral modular prosthesis, either on a total hip, or bipolar articulations from January 2016 to June 2019. Results: One year MSTS score was statistically significantly better in the total hip group than in the bipolar group; 26.32 points (range 22-30), and 24.10 points (18-29) respectively (P-value: 0.007), as well as One year HHS; 90.53% (range 64-100), and 87.55 (range 65-96) respectively (P value 0.32). No statistically significant difference regarding dislocation incidence was found between the total hip group and the bipolar group; 4.8%, and 6.1% respectively (P-value: 1). Theacetabular erosion rate for the bipolar proximal femoral modular prosthesis was 27.3% with a mean postoperative time of 81.50 months (range 36-172 months)

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