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Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 349 - 349
1 Jul 2011
Papageorgiou K tilaveridis P Hatizioannidis A Papageorgiou I Christodoulou S Gerakas S
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The revision of the hip surgery belongs to the major orthopaedic surgery and the purpose of our research is the presentation of our experience.

During the period 2004–2008, revision in surgery of the hip was performed in 15 patients, while most of them were women with average 73 years. 190 subcapital fractures were revisioned in 7 patients, 277 pertrochanteric fractures in 3 patients, 75 total arthroplasties in 5 patients and all of them were bipolar arthroplasties and osteosynthesis with DSH plate. The average interval between the primary operation and revision arthroplasty was 28 months, revision of the acetabular was performed in 3, revision of the femoral in 1 and regarding to the other patients both types of revision were performed. According to Paprosky classification we noted lesions of type I and type II and in 13 cases operation was made in a time. Early complications appeared in 6 patients (mostly postoperative infections). For the stabilization of the acetabular we used supporting rings with bone grafts or press fit acetabulars without cement, while for the femoral, according to the injury extend and the bone quality, the stabilization of the stem was made with cement. The average follow-up time was 20 months, we re-examined 14/15 patients and chronic complications appeared in 2 patients. The final result was satisfactory, according to Harris-Hip score with the radiological evaluation.

Conclusively, hip revisions are difficult and demanding operations, accompanied by serious complications. For their success good preoperative planning, experience and complete material-technical supporting are required with use, most of the times, of custom made prosthesis, supporting rings of the acetabular with bone graft.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 354 - 354
1 Jul 2011
Papageorgiou K Papageorgiou I Tilaveridid P Voutsas D Chatzioannidis A Gerakas S
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Periprosthetic fractures represent a challenging problem in joint arthroplasty the incidence of which seems to be increasing due to the big number of the arthroplasties and the increasing average life expectancy.

The purpose of this study is to present the methods of treatment, the problems that we have to solve intra-operatively and our long term results about the healing procedure and the fuctional restoration.

Between 2000–2008 we operated 15 femoral peri-prosthetic fractures(1 re-fracture). 10 of them were after hip arthroplasties.

The classification which used was Lewis-Rorabeck for the fractures after TKR and Vancouver for them after THA.

Cause of fracture was fall and the time interval from the primary operation was 1–14 years. The majority of the patients were women(14), and the mean age 65 years.

13 of the 15 fractures were treated with ORIF and the remaining two need to be revised. During the follow up 2 of them died due to other pathological problems. The post op follow up ranged from 1–8(3.5)years.

The postoperative evaluation was done according the Harris Hip Score and the Knee Society Clinical Rating System.

The fractures healed after a mean time of 6 months. Two postoperative wound infections were registered to the revised fractures and their treatment were successful with surgical debridement.

All the patients are in good health condition, moving with some kind of support and they are selfreserved.

As a conclusion we believe that this kind of fractures demand the proper surgical planning, prediction of all possible complications and the cooperation of other specialties and physiotherapisties.


Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 225 - 225
1 Mar 2003
Gerakas S Vassiliadis E Bouras A Gaindatzis I Vradelis K
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Purpose: The aim of our study is to compare the outcome of Bipolar Artroplasty (BA) and Total Hip Arthroplasty (THA) in active middle-aged patients with displaced intracapsular femoral neck fractures. Material and Methods: From October 1993 until October 1997, 43 patients (6 male, 37 female) were treated with the above two methods (25 underwent BA and 18 THA), when satisfactory reduction of the fracture was not achievable or survival of femoral head was uncertain. The patients were from 55 to 76 years of age (mean 64, 8 years).

Thirty-eight patients (22 with BA and 16 with THA) were reviewed after a mean of 5, 8 years (ranging from 3 to 8 years).

Results: Comparing the clinical results we found no statistical significant difference between the two methods. Mean Harris Hip Score in BA was 89 (range 71–100) and in THA was 88 (range 74–100). The motion of the inner component of BA was 24% of total in weightbearing conditions and 17, 7% in non-weightbearing condition, as it was measured radiographically.

Conclusion: Despite our small number of patients, the results of BA are comparable to those of THA. Considering that BA it’s a more simple method, reduces the operation time, eliminates blood transfusions and is less expensive, it seems that BA is a rational method of treatment for this group of patients. THA should be reserved for patients with displaced femoral neck fractures with pre-existing hip disease (rheumatoid arthritis, osteoartritis, Paget disease).