Is the position of dual-mobility cup in THA for femoral neck fractures optimal? A retrospective study

2019 ◽  
Vol 30 (2) ◽  
pp. 275-280 ◽  
Author(s):  
Pierre-Alban Bouche ◽  
Simon Corsia ◽  
Baptiste Boukebous ◽  
Pierre Boutroux ◽  
Redoine Zahi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Dual Mobility Cup ◽  
Dual Mobility

scholarly journals Dual-Mobility Cup Total Hip Arthroplasty for Displaced Femoral Neck Fractures: A Retrospective Study With a Median Follow-Up of 5 Years

2021 ◽  
Vol 12 ◽  
pp. 215145932110132
Author(s):  
Zhenfa Zhang ◽  
Guixing Xu ◽  
Lei Cao ◽  
Wei Sun ◽  
Xianshang Zeng ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Complication Rate ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Total Hip

Introduction: Patient outcomes following modern dual-mobility cup total hip arthroplasty (DM-THA) remains a concern. Few reports have focused on the use of modern DM-THA in the setting of Asian populations for displaced osteoporotic femoral neck fractures (FNFs). This study aimed to investigate the outcomes of Chinese population with displaced osteoporotic FNFs initially treated with modern DM-THA. Materials and Methods: Data from 112 consecutive patients (112 hips) with displaced osteoporotic FNFs initially treated with modern DM-THA during 2011-2018 were retrospectively analyzed. Follow-ups were performed at 3 months, 6 months, 12 months, and then every 1 year after surgery. The primary endpoint was the Harris Hip Score (HHS); the secondary endpoint was the main orthopedic complication rate. Results: The mean HHS improved from 58.62 (±15.79) prior to surgery to 86.13 (±9.92) at the final follow-up. The main complication rate was 14.2% (16/112). Sixteen complications in 10 patients were recorded. Of the 16 complications, there were 2 (1.7%) cases requiring revision DM-THA, 3 (2.6%) cases of loosening, 2 (1.7%) cases of migration, 3 (2.6%) intra-prosthetic dislocation (IPD), 4 (3.5%) cases of tilting, and 2 (1.7%) cases of severe wear. The need for revision was attributed to prosthesis loosening associated with poor bony quality. Conclusion: In patients with displaced osteoporotic FNFs, DM-THA may yield favorable functional outcomes and a low rate of main orthopedic complications, in particular, a low dislocation rate.

Dual mobility total hip arthroplasty in the treatment of femoral neck fractures

2020 ◽  
Vol 102-B (11) ◽  
pp. 1457-1466 ◽  
Author(s):  
Yong-Han Cha ◽  
Jun-Il Yoo ◽  
Jung-Taek Kim ◽  
Chan-Ho Park ◽  
Young-Sun Ahn ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Cohort Studies ◽  
Surgical Site Infection ◽  
Comparative Studies ◽  
Femoral Neck Fractures ◽  
Dislocation Rate ◽  
Site Infection ◽  
Dual Mobility ◽  
One Year

Aims To evaluate the rate of dislocation following dual mobility total hip arthroplasty (DM-THA) in patients with displaced femoral neck fractures, and to compare rates of dislocation, surgical-site infection, reoperation, and one-year mortality between DM-THA and bipolar hemiarthroplasty (BHA). Methods Studies were selected based on the following criteria: 1) study design (retrospective cohort studies, prospective cohort studies, retrospective comparative studies, prospective comparative studies, and randomized controlled studies (RCTs)); 2) study population (patients with femoral neck fracture); 3) intervention (DM-THA or BHA); and 4) outcomes (complications during postoperative follow-up and clinical results). Pooled meta-analysis was carried out to evaluate the dislocation rate after DM-THA and to compare outcomes between DM-THA and BHA. Results A total of 17 studies (ten cohort studies on DM-THA and seven comparative studies of DM-THA and BHA) were selected. These studies included 2,793 patients (2,799 hips), made up of 2,263 DM-THA patients (2,269 hips) and 530 BHA patients (530 hips). In all, 16 studies were analyzed to evaluate dislocation rate after DM-THA. The cumulative dislocation rate was 4% (95% confidence interval (CI) 3 to 5). Seven studies were analyzed to compare the rates dislocation and surgical-site infection. The rate of dislocation was significantly lower in the DM-THA group than in the BHA group (risk ratio (RR) 0.3; 95% CI 0.17 to 0.53, p < 0.001, Z −4.11). There was no significant difference in the rate of surgical-site infection between the two groups (p = 0.580). Six studies reported all-cause reoperations. The rate of reoperation was significantly lower in the DM-THA group than in the BHA group (RR 0.5; 95% CI 0.32 to 0.78, p = 0.003, Z −3.01). Five studies reported one-year mortality. The mortality rate was significantly lower in the DM-THA group than in the BHA group (RR 0.58 95% CI 0.45 to 0.75, p < 0.0001, Z −4.2). Conclusion While the evidence available consisted mainly of non-randomized studies, DM-THA appeared to be a viable option for patients with displaced fractures of the femoral neck, with better reported rates of dislocation, reoperation, and mortality than BHA. Cite this article: Bone Joint J 2020;102-B(11):1457–1466.

scholarly journals Dual Mobility Acetabular Cup Versus Hemiarthroplasty in Treatment of Displaced Femoral Neck Fractures in Elderly Patients: Comparative Study and Results at Minimum 3-Year Follow-up

2019 ◽  
Vol 10 ◽  
pp. 215145931984861 ◽  
Author(s):  
Skender Ukaj ◽  
Osman Zhuri ◽  
Fatime Ukaj ◽  
Vlora Podvorica ◽  
Kushtrim Grezda ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fractures ◽  
Dislocation Rate ◽  
Harris Hip Score ◽  
Elderly Persons ◽  
Dual Mobility ◽  
Displaced Femoral Neck Fractures ◽  
Significant Difference ◽  
Duration Of Surgery

Background: Hip fractures are serious injuries associated with relatively high mortality rates and disabilities, commonly seen in elderly persons. There is an ongoing debate regarding the advantages of various hip arthroplasty devices. This study aimed to analyze the long-term advantages of 2 different surgical procedures and assess if the dislocation rate, Harris Hip Score (HHS), and functional independence measure (FIM) are more favorable in dual mobility (DM) than those in hemiarthroplasty (HA). Hypothesis: Dual mobility procedures provide better postoperative outcomes than HA in terms of HHS, FIM, and dislocation rate. Materials and Methods: The survey was a prospective, comparative interventional single-blinded study performed at the University Clinical Center of Kosovo, a tertiary health-care institution. A total of 94 patients underwent DM or conventional bipolar HA for repair of displaced femoral neck fractures within 2 weeks of injury. Primary outcomes were postoperative dislocation rate, FIM, and HHS. Secondary outcomes included duration of surgery, estimated intraoperative blood loss, time to first postoperative full weight-bearing, time to walking ability with and without crutches, mortality rate, and postoperative infection rate. Results: There were no significant differences for most parameters between the groups. We found a significant difference in the dislocation rate between the 2 groups, wherein there were no dislocations in the DM group and 3 dislocations in the HHS group (0% vs 6.4%). In terms of postoperative HHS at 12 months and 3 years, DM provided better outcomes (<0.034 and <0.014, respectively). Discussion: Dual mobility compares favorably to HA in terms of dislocation rate and HHS, while no difference was found for FIM. In order to have a more complete overview, we recommend more intense long-term studies including several heterogeneous parameters to compare the clinical outcomes between DM and HA. Level of evidence (with study design): Level II.

scholarly journals Association of dyslipidemia with chronic non-malignant pain in elderly patients with femoral neck fractures treated by primary total hip arthroplasty: a retrospective study

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110452
Author(s):  
Chen Wang ◽  
Bo Xu ◽  
Pengfei Wang ◽  
Weiguang Yu ◽  
Xianshang Zeng ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Retrospective Study ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Logistic Regression Model ◽  
Density Lipoprotein ◽  
Binary Logistic Regression ◽  
Femoral Neck Fractures ◽  
Binary Logistic Regression Model

Objective The association of chronic non-malignant pain (CNP) with dyslipidemia is unclear. This retrospective study was performed to evaluate the association between CNP and dyslipidemia in elderly patients with femoral neck fractures (FNFs) treated by primary unilateral total hip arthroplasty (THA). Methods We retrospectively identified 521 consecutive patients with FNFs (AO/OTA type 31B) who underwent primary unilateral THA from 2009 to 2021. The study population was divided into patients with and without CNP. Serum lipids were measured for each patient. The association between CNP and dyslipidemia was assessed using a multivariate binary logistic regression model. Results In total, 436 patients (220 with CNP, 216 without CNP) were eligible for analysis. In the quantile regression, the adverse effect of CNP was significantly attenuated by resilience in patients with a high high-density lipoprotein (HDL) concentration and low low-density lipoprotein (LDL) concentration. The multivariate binary logistic regression model showed that the HDL and LDL concentrations were the only variables significantly associated with the development of CNP. Conclusion Both a low HDL and high LDL concentration may result in the occurrence of CNP in elderly patients with FNFs treated by primary unilateral THA.

Comparison of functional outcome of cemented total hip replacement versus cemented dual-mobility cup total hip replacement for the management of displaced femoral neck fractures in the active elderly patients

2020 ◽  
pp. 112070002091041 ◽  
Author(s):  
Ramy A M Rashed ◽  
Hannah Sevenoaks ◽  
Qaisar A Choudry ◽  
Mohammed S Kasem ◽  
Tarek A Elkhadrawe ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Elderly Patients ◽  
Range Of Motion ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Neck Fractures ◽  
Dual Mobility ◽  
Total Hip ◽  
Displaced Femoral Neck Fractures ◽  
Hip Replacements

Introduction: Current guidelines recommend treating displaced femoral neck fractures with a total hip replacement in fit and active elderly patients. Dislocation remains the main complication. Dual-mobility cup (DMC) hip replacements maybe a solution to decrease dislocation, with the benefit of increasing stability, achieving better range of motion and functional outcomes. Patients and methods: This is a prospective randomised controlled trial which included 62 patients with Garden III and IV femoral neck fractures. The mean age was 67.2 years. 30 males and 32 females were included, randomised and allocated to 2 treatment groups; a cemented DMC replacement group, or a cemented 32-mm head total hip replacement (THR). The posterior approach was used in all patients. Postoperative functional outcome was assessed using Harris Hip Score (HHS). Health-related quality of life (HRQoL) was assessed using the SF-36 questionnaire. Results: The mean HHS for the DMC group at 4, 6 and 12 months were higher than mean HHS scores for the THR group ( p < 0.001). The range of motion at 1 year was statistically better in the DMC group compared to the THR group ( p < 0.001). The DMC showed a statistically better effect on the HRQoL measurements as compared to the THR group. There were no dislocations in both groups. Conclusions: DMC hip replacements provide better functional, patient reported outcomes, and range of motion than the conventional THR. Combined with its stability, DMC replacements are a useful solution in managing femoral neck fractures in active elderly patients. Trial serial number 020841 (IRB Number 00007555).

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