Choice of Approach, but Not Femoral Head Size, Affects Revision Rate Due to Dislocations in THA After Femoral Neck Fracture: Results from the Lithuanian Arthroplasty Register

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2014 Dec 17

PMID 25512138

Citations 8

Authors

Algimantas Cebatorius

Otto Robertsson

Justinas Stucinskas

Alfredas Smailys

Linas Leonas

Sarunas Tarasevicius

Affiliations

Soon will be listed here.

Abstract

Purpose: Hip dislocation after arthroplasty for femoral neck fractures (FNF) remains a serious complication. The aim of our study was to investigate FNF patients treated with THA, with a special focus of comparing the effect of surgical approach and femoral head size on the risk of revision for dislocation.

Methods: Data were derived from the Lithuanian Arthroplasty Register, and we calculated the cumulative revision rates after surgery. For survival analysis, we used revision due to dislocation as an end-point. Cox proportional hazards models were used to analyse the influence of various covariates (age, gender, femoral head size, surgical approach).

Results: A total of 8,813 primary THAs were registered from 1 January 2011 to 31 December 2013, of which 1,412 were due to FNF: 899 involved 28-mm femoral heads and the remaining 513 received 32-mm heads. The posterior approach was used in 1,156 cases and the anterolateral approach in 256.. At the end of the follow-up period, 74 hips had been revised for recurrent dislocation. Cox regression adjusting for age, gender and head size showed that the posterior approach had 2.3-times [95% confidence interval (CI): 1.0-5.0, p = 0.04] greater risk of revision for dislocation

Conclusions: We conclude that in order to reduce the early dislocation rate in FNF patients treated with THA, it is more effective to use the anterolateral approach than it is to select a femoral head size of 32 mm instead of 28 mm.

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