1. Bipolar Hemiarthroplasty – Does It Make Sense in AVNF?
Chun-Hsiung Shih, M.D.
Superintendent, Taipei Chung Shan General Hospital
Visiting Professor, Department of Orthopaedic Surgery, Chang-Gung Memorial Hospital
2018年12月4日

2. Treatments of AVNF Ficat I, II : Medication (e.g. Fosamax etc.)
Shock wave, HBO
Core decompression
Bone graft (vascularized, non-vascularized)
Osteotomy (varus, valgus, rotational)
Others
Ficat III: Bipolar, THA
Ficat IV: THA

3. Bipolar < THA in AVNF
Clinical Result
THA : AVNF < O.A.
Bipolar < THA in AVNF

5. Bipolar vs. Total Hip Arthroplasty for Hip Osteonecrosis in the Same Patient
Yi-Sheng Chan, M.D. and Chun-Hsiung Shih, M.D*
*source: Clinical Orthopaedics 379: , 2000

6. Materials and Methods 1986-1994
28 patients (26M/2F); average age: 44.6 (23-58)
Bilateral AVNF, one side hip Bipolar (Ficat III) and other side THA (Ficat III or IV)
Osteonics type of prosthesis
Non-cemented
Followup 6.5 years (4-12 years)

7. Comparison of Clinical Results
Parameter
Bipolar Side
THA Side
P-value
Satisfactory Rate
85.7%
82%
> 0.05
Thigh Pain
7.2%
10.7%
Groin Pain

8. Comparison of Complications
Parameter
Bipolar Side
THA Side
P-value
Revision of Component
Femoral Cpt.
Acetabular Cpt.
1 (3.6%)
2 (7.2%)
> 0.05
Osteolysis
5 (18%)
< 0.05
Dislocation

18. Discussion Causes of unfavorable results in the previous reports
Cartilage damage of the acetabular side
Mismatch of Bipolar head to the acetabulum
Soft tissue tension of the hips after operations
Individual’s tolerance difference in pain and discomfort

19. Advantage of Bipolar Endoprosthesis
Less dislocation
Less PE wear and osteolysis
Buy time for further revision
Easier revision

35. thank you...