Dislocation Rate, Revisions and Other Complications of Primary Cemented Hemiarthroplasty for Displaced Femoral Neck Fractures: a Single-center Cohort Study of 743 Unselected Hips with a Mean 2.7-year Follow-up

Overview

Journal Arch Orthop Trauma Surg

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2021 Nov 15

PMID 34779885

Citations 2

Authors

Mats Bue

Stig Storgaard Jakobsen

Jeppe Barckman

Steffan Tabori-Jensen

Affiliations

Soon will be listed here.

Abstract

Introduction: Evidence of whether to use hemiarthroplasty (HA) or total hip arthroplasty for displaced femoral neck fractures (FNF) is still widely debated, especially when taking ambulatory status, age, and patient cognitive status into account. The current study aims to report the rates of dislocations, revisions and other complications for primary cemented HA in patients with displaced FNF.

Materials And Methods: Single-center retrospective follow-up study of an unselected historic cohort. 743 consecutive hips (551 W and 192 M) at mean (SD) age of 83.6 (8.4) years received primary cemented HA for displaced FNF by posterolateral surgical approach between January 2012 and December 2019. Patient files and radiographs were evaluated for dislocations, revisions, and other complications until death or end of the follow-up period, and the educational level of the surgeon was noted.

Results: During a mean (SD) follow-up period of 2.7 (2.2) years, there were 6.1% (n = 45) dislocations, in which 82% (first dislocation) appeared within the first 30 postoperative days, and 51% (n = 23) of the dislocations requiring subsequent surgery. At the time of the last available follow-up, 57% (n = 421) of the patients were dead. A non-dislocation related revision was needed in 3.4% (n = 25) of the patients [in which infection accounted for 40% (n = 10) and traumatic periprosthetic fracture for 32% (n = 8)]. Thirty-day mortality was 9.2% and 1-year mortality 25.8%. There were no differences in patient's age, gender, or educational level of the surgeon between the dislocation and the no dislocation groups. Patients aged < 70 years presented with a higher dislocation rate (p < 0.001) than the patients aged > 70 years.

Conclusion: Primary HA presents a safe and robust approach with acceptable complication rates in a genuine unselected cohort of displaced FNF, particularly for patients aged > 70.

Citing Articles

Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures.

Tanaka H, Mori Y, Noro A, Yano T, Aizawa T, Masuda K Medicina (Kaunas). 2024; 60(3).

PMID: 38541082 PMC: 10972245. DOI: 10.3390/medicina60030356.

Dislocation rate after hip arthroplasty due to metastatic bone disease: a retrospective cohort study evaluating the postoperative dislocation risk across different articulating solutions.

Iljazi A, Sorensen M, Ladegaard T, Overgaard S, Petersen M Acta Orthop. 2023; 94:107-114.

PMID: 36877133 PMC: 9987322. DOI: 10.2340/17453674.2023.10311.

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