1.Femoral Stem Subsidence and its Associated Factors after Cementless Bipolar Hemiarthroplasty in Geriatric Patients
Gema A ; Irianto KA ; Setiawati R
Malaysian Orthopaedic Journal 2021;15(No.1):63-71
Introduction: Early femoral stem subsidence has been a
concern as a predictor of the beginning of implant loosening,
especially on cementless hip arthroplasty implants. This
study aimed to determine the factors that affect femoral stem
subsidence and outcome following hemiarthroplasty in the
geriatric population.
Materials and Methods: This is a retrospective study of 179
patients who underwent cementless bipolar hemiarthroplasty
during the 2011-2019 period at an orthopaedic and
traumatology hospital. Data on the patient's demography,
pre-operative American Society Anaesthesiologist (ASA)
score, body mass index (BMI), canal flare index (CFI), Dorr
classification, and stem alignment were obtained. The
primary outcomes were post-operative femoral stem
subsidence, post-operative pain, and functional outcome
using Harris Hip Score (HHS). Statistical analysis was
conducted to identify risk factors associated with the primary
outcome.
Results: The mean femoral stem subsidence was 2.16 ±3.4
mm. The mean post-operative Visual Analog Score (VAS) on
follow-up was 1.38 ± 1. Mean HHS on follow-up was
85.28±10.3. American Society Anaesthesiologist score 3 (p =
0.011, OR = 2.77) and varus alignment (p=0.039, OR =
6.963) were related to worse stem subsidence. Otherwise,
neutral alignment (p = 0.045 and OR = 0.405) gave
protection against femoral stem subsidence. The female
gender (p = 0.014, OR 2.53) was associated with postoperative pain onset. Neutral alignment had significant
relationship with functional outcomes (p = 0.01; OR 0.33).
Conclusion: A higher ASA score and varus stem alignment
were related to a higher risk of femoral stem subsidence.
Meanwhile, neutral stem alignment had a protective effect on
the femoral stem subsidence and outcome.
2.Platelet Rich Plasma Injection for Soft Tissue Musculoskeletal Pain
Irianto KA ; Bakri AH ; Kloping NA
Malaysian Orthopaedic Journal 2021;15(No.2):96-100