Background: Blind individuals are more prone to falls and subsequent proximal femoral fractures. While hip Hemiarthroplasty is a common treatment option for displaced femoral neck fractures in the elderly, evidence regarding the outcomes of hip Hemiarthroplasty in blind individuals is still lacking.Objectives: This retrospective study aimed to evaluate the clinical and radiographic outcomes among a series of blind patients who received hip Hemiarthroplasty for femoral neck fractures.Methods: Fifteen patients (15 cases, 11 females) with a mean age of 79.7 years (range, 59-100) at the time of surgery were included in this study. Seven patients were bilaterally blind, while eight patients had unilateral blindness. All of the patients received hip Hemiarthroplasty (10 received bipolar and 5 unipolar Hemiarthroplasty) for displaced femoral neck or proximal femoral fractures.Results: The mean follow-up for all patients is 49 months. At their last follow-up visits, fourteen cases were able to bear weight fully with or without assistive devices while one patient was wheelchair-bound. The mean calculated pre-injury, and last follow-up postoperative Parker Mobility Index for all patients were 4.7 and 4.5, respectively (p=.8). Three patients (20%) had subsequent, recurrent falls that resulted in other skeletal fractures without Hemiarthroplasty dislocations or periprosthetic fractures. One patient developed a prosthetic joint infection and was managed with surgical debridement and antibiotic spacer placement.Conclusions: Hip Hemiarthroplasty is a practical treatment option for elderly blind individuals who suffer from displaced femoral neck fractures with overall good implant-related outcomes. Patients should be counseled about the incidence of postoperative recurrent falls and should be instructed to use assistive devices during ambulation.

Background: Shoulder Hemiarthroplasty is one of the established methods for management of proximal humerus fractures particularly in the types with more displacement so that fixation is not possible. Successful treatment is a challenge for shoulder surgeons especially in elderly patients. The aim of this study is to investigate the functional results and prognostic factors on shoulder Hemiarthroplasty.Methods: Thirty nine patients operated by one shoulder surgeon in Imam Khomeini and Shariati Hospital in Tehran, Iran, from October 2005 to February 2009 were included in this study and followed postoperatively for at least one year. Mean (±SD) age was 49.7±14.3 years. Functional results were measured by constant score and pain was scored using visual analogue score. The relationship between factors such as age, injury to surgery interval, radiographic parameters and functional results were assessed.Results: Mean (±SD) constant score was 61.9±20.2. The age and injury to surgery interval showed a reverse correlation with constant score (p<0.05). There was a significant correlation between constant score and acromiohumeral interval (r=0.53) and head to tuberusity distance (-0.59). Median VAS score was 4.5 (interquartile range: 2-5.2) that had a direct correlation with age (r=0.38) and injury to surgery interval (r=0.55) (p<0.05).Conclusions: Shoulder Hemiarthroplasty should be performed in minimal delay from injury and this operation should be performed by an experienced shoulder surgeon to create the best anatomic position of prostheses. Careful rehabilitation particularly in older patients is very important to improve results.

Introduction: In developing countries, the Hemiarthroplasty surgical procedure is applied for many patients with hip fractures. These surgical interventions occur with a delay because of various reasons, including insufficient hospital facilities and the deficiency of the ICU beds. Therefore, this study aimed to assess the consequences and complications of delayed Hemiarthroplasty in the elderly (>60 years of age) with intertrochanteric and femoral neck fractures, regarding a 1-year follow-up. Methods: This retrospective cross-sectional study evaluated 392 patients (59. 2% female and 40. 8% male,Mean±, SD age: 69. 9±, 4. 7 years) according to the presence or absence of postsurgical complications, including the limbs shortening, infection, hematoma, symptomatic pulmonary embolism, Harris hip score, and the number of deaths following cemented bipolar Hemiarthroplasty. Results: The majority of the patients (82. 9%) underwent surgery in public hospitals, and 34% of them had femoral neck fractures. The evaluation of the trauma-surgery time interval index revealed that 39% of patients had delayed surgery (24% of which received surgery on the third day and 15. 1% on the fourth day after hospital admission). The trauma-surgery time interval was significantly associated with infection (6. 6%), hematoma (4. 1%), embolism (2. 8%), and deep vein thrombosis (4. 8%) (P<0. 05). The mortality rate was 0. 5% (2 cases), 1% (4 cases), and 1. 3% (5 cases) in the first month, 1 to 6 months, and 6 to 12 months, respectively. Also, in the first month, this analysis showed a significant (P<0. 05) association between mortality rate and increased trauma-surgery time interval. According to the functional outcomes, patients with delayed surgery represented the decreased levels of Harris hip score. Conclusion: Rapid preparation of elderly patients for Hemiarthroplasty is considered an effective factor to reduce morbidity and mortality rates.

Background: The projected increase in revision shoulder arthroplasty has increased interest in the outcomes of these procedures. Glenoid component removal and conversion to a Hemiarthroplasty (HA) is an option for aseptic glenoid loosening after anatomic total shoulder arthroplasty (aTSA). Methods: We identified patients who had undergone revision shoulder arthroplasty over a 15-year period. 17 patients met inclusion and exclusion criteria, and a retrospective chart review was conducted for pre-surgical and operative data. We contacted patients at a mean follow-up of 70 months from revision surgery for implant survival, reoperations and functional outcomes scores. Results: Implant survival was estimated to be 88% at 2 years and 67% at 5 years. Mean ASES score for surviving implants was 58 ± 22. Mean SANE score was 54 ± 24, and mean VAS pain score was 3. 5 ± 2. 8. Mean SF-12 Mental and Physical scores were 46 ± 15 and 38 ± 10, respectively. Five patients (50% of those with surviving implants) reported being either very satisfied or satisfied with the status of their shoulder. There were complications in 6 patients (35%) and 5 patients (29%) required reoperation. Conclusion: HA following failed aTSA due to glenoid loosening produced modest clinical results and satisfaction rates. Reverse arthroplasty may be a more reliable treatment strategy in this patient population.

Background: Hip fractures are among the top ten causes of disability in adults worldwide. Patients with hip fracture are at significant risk of mortality and morbidity and reduced quality of life. This study was conducted with the aim of investigating the effect of intra-articular vancomycin in preventing infection in patients undergoing hip Hemiarthroplasty. Materials and Methods: This double-blind controlled clinical trial study was conducted on 48 patients with femoral neck fracture candidates for hip Hemiarthroplasty Hemiarthroplasty in Orthopedic clinic of Golestan and Imam Khomeini Hospital, Ahvaz, Iran between June and November 2023. Eligible patients were divided into two equal groups. The intervention group received 1gram vancomycin intra-articularly during the operation before closure of fascia, and the control group did not receive vancomycin. The patients were followed up for 6 months after the operation, and the rate of superficial infection, periprosthetic joint infection (PJI) and wound complications were compared in two groups. The obtained data were statistically analyzed with IBM SPSS Statistics 21. 0 for Windows. Results: The vancomycin group and the control group had no significant difference in the incidence of overall infection. The PJI in vancomycin and control groups were 4. 16% and 8. 33%, respectively. This difference was not statistically considerable (P=0. 55). The results showed the incidence of superficial estimated 8. 33% in vancomycin group and 4. 16% in control group with no considerable difference in infection (P=0. 52). Moreover, there was no meaningful difference in side effects between the two groups (P=0. 63). There was no significant difference in wound complications between the two groups (P=0. 3). . Conclusion: Intra-articular injection of 1gram of vancomycin suspension did not reduce the overall, superficial and deep infection after surgery. It is suggested that more clinical trial studies with higher sample size be conducted in order to determine the effect of intra-articular vancomycin in preventing infection in patients undergoing hip Hemiarthroplasty