Do Dual-Mobility Cups Reduce the Risk of Dislocation in Total Hip Arthroplasty for Fractured Neck of Femur in Patients Aged Older Than 75 Years?

Abstract Background Total hip arthroplasty (THA) for intracapsular neck of femur (NOF) fracture remains debatable as it is associated with higher rates of dislocation, notably in the older part of the population. We hypothesized this risk could be limited using dual-mobility cups (DMCs). Methods Eig...

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Veröffentlicht in:The Journal of arthroplasty 2016-06, Vol.31 (6), p.1256-1260
Hauptverfasser: Nich, Christophe, MD, PhD, Vandenbussche, Eric, MD, PhD, Augereau, Bernard, MD, Sadaka, Jérôme, MD
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Sprache:eng
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Zusammenfassung:Abstract Background Total hip arthroplasty (THA) for intracapsular neck of femur (NOF) fracture remains debatable as it is associated with higher rates of dislocation, notably in the older part of the population. We hypothesized this risk could be limited using dual-mobility cups (DMCs). Methods Eighty-two patients (83 hips) aged older than 75 years underwent DMC-THA using a posterolateral approach for an intracapsular NOF fracture. Results Clinical data were collected in 45 patients at a mean of 23.8 ± 9.4 months (12.1-42 months). The mortality rates were 19% (16 patients) and 36.5% (30 patients) at 1 year postoperatively and at the last follow-up, respectively. Postoperatively, there were 2 dislocations of the large articulation (4.4%) and one intraprosthetic dislocation (2.2%), all related to technical errors. Functional results were rated at least good in 71% cases, whereas the Parker and Devane scores were stable, indicating optimal restoration of autonomy and physical activity. Conclusion Although technically demanding, DMC-THA may prevent dislocation in intracapsular NOF fracture in elderly patients, while consistently limiting the risk of loss of independence.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2015.11.041