No Difference in Dislocation Rates Comparing DMC-THA for Displaced Femoral Neck Fracture and for Osteoarthritis-A Matched-Pair Analysis

Overview

Journal Indian J Orthop

Publisher Springer Nature

Specialty Orthopedics

Date 2023 Feb 24

PMID 36825264

Authors

Lucie Regennass

Kevin Brulefert

Fanny Feuillet

Christophe Nich

Affiliations

Soon will be listed here.

Abstract

Background: We hypothesized the risk of prosthetic instability would be similar in patients treated for femoral neck fracture (FNF) comparatively to patients treated for osteoarthritis (OA) using a dual-mobility cup-total hip arthroplasty (DMC-THA).

Methods: One hundred and nine patients (109 hips), with a mean age of 69.6 ± 3 years (65-75 years), underwent DMC-THA using a posterolateral approach for a FNF (study group). Patients were matched for age and sex with 109 OA patients treated by the same procedure (control).

Results: Postoperatively, there were four dislocations of the large articulation in the study group, and none in the control ( = 0.12). Periprosthetic joint infection (PJI) was the most common surgical complication and was more frequent in the study group. Postoperatively, functional results were at least good in > 90% patients in both groups. At the last follow-up, patients in the study group had recovered autonomy and physical activity comparable to those of the preoperative period.

Conclusion: We found no increased risk of dislocation after DMC-THA using a posterolateral approach for FNF as compared to the same procedure for OA. In this study, function and independence were restored postoperatively in the vast majority of patients. DMC-THA appears as a viable therapeutic option in autonomous patients with a displaced FNF.

Citing Articles

Letter to the editor regarding Obada et al.: Clinical outcomes of total hip arthroplasty after femoral neck fractures vs. osteoarthritis at one year follow up-a comparative, retrospective study. doi: 10.1007/s00264-024-06242-0.

Nich C Int Orthop. 2024; 48(11):3017-3018.

PMID: 39299948 DOI: 10.1007/s00264-024-06311-4.

References

DeLee J, CHARNLEY J . Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976; (121):20-32. View

Parker M, Gurusamy K . Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev. 2006; (3):CD001706. DOI: 10.1002/14651858.CD001706.pub3. View

Gruen T, McNeice G, Amstutz H . "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979; (141):17-27. View

Cooper C, Cole Z, Holroyd C, Earl S, Harvey N, Dennison E . Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. 2011; 22(5):1277-88. PMC: 3546313. DOI: 10.1007/s00198-011-1601-6. View

Chia P, Gualano L, Seevanayagam S, Weinberg L . Outcomes following fractured neck of femurin an Australian metropolitan teaching hospital. Bone Joint Res. 2013; 2(8):162-8. PMC: 3746209. DOI: 10.1302/2046-3758.28.2000177. View

Philippot R, Camilleri J, Boyer B, Adam P, Farizon F . The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop. 2008; 33(4):927-32. PMC: 2899002. DOI: 10.1007/s00264-008-0589-9. View

Hamadouche M, Biau D, Huten D, Musset T, Gaucher F . The use of a cemented dual mobility socket to treat recurrent dislocation. Clin Orthop Relat Res. 2010; 468(12):3248-54. PMC: 2974879. DOI: 10.1007/s11999-010-1404-7. View

Wang F, Zhang H, Zhang Z, Ma C, Feng X . Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis. BMC Musculoskelet Disord. 2015; 16:229. PMC: 4552391. DOI: 10.1186/s12891-015-0696-x. View

Tarasevicius S, Busevicius M, Robertsson O, Wingstrand H . Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture. BMC Musculoskelet Disord. 2010; 11:175. PMC: 2922087. DOI: 10.1186/1471-2474-11-175. View

10.

Sterling R . Gender and race/ethnicity differences in hip fracture incidence, morbidity, mortality, and function. Clin Orthop Relat Res. 2010; 469(7):1913-8. PMC: 3111795. DOI: 10.1007/s11999-010-1736-3. View

11.

Kurtz S, Lau E, Ong K, Adler E, Kolisek F, Manley M . Hospital, Patient, and Clinical Factors Influence 30- and 90-Day Readmission After Primary Total Hip Arthroplasty. J Arthroplasty. 2016; 31(10):2130-8. DOI: 10.1016/j.arth.2016.03.041. View

12.

Burgers P, van Geene A, van den Bekerom M, Van Lieshout E, Blom B, Aleem I . Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis and systematic review of randomized trials. Int Orthop. 2012; 36(8):1549-60. PMC: 3535035. DOI: 10.1007/s00264-012-1569-7. View

13.

Engh C, Bobyn J, Glassman A . Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987; 69(1):45-55. DOI: 10.1302/0301-620X.69B1.3818732. View

14.

Boyer B, Philippot R, Geringer J, Farizon F . Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips. Int Orthop. 2011; 36(3):511-8. PMC: 3291786. DOI: 10.1007/s00264-011-1289-4. View

15.

Nich C, Vandenbussche E, Augereau B, Sadaka J . 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?. J Arthroplasty. 2016; 31(6):1256-1260. DOI: 10.1016/j.arth.2015.11.041. View

16.

Adam P, Philippe R, Ehlinger M, Roche O, Bonnomet F, Mole D . Dual mobility cups hip arthroplasty as a treatment for displaced fracture of the femoral neck in the elderly. A prospective, systematic, multicenter study with specific focus on postoperative dislocation. Orthop Traumatol Surg Res. 2012; 98(3):296-300. DOI: 10.1016/j.otsr.2012.01.005. View

17.

Homma Y, Baba T, Ozaki Y, Watari T, Kobayashi H, Ochi H . In total hip arthroplasty via the direct anterior approach, a dual-mobility cup prevents dislocation as effectively in hip fracture as in osteoarthritis. Int Orthop. 2016; 41(3):491-497. DOI: 10.1007/s00264-016-3332-y. View

18.

Bensen A, Jakobsen T, Krarup N . Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures. Int Orthop. 2014; 38(6):1241-5. PMC: 4037505. DOI: 10.1007/s00264-013-2276-8. View

19.

Devane P, Horne J, Martin K, Coldham G, Krause B . Three-dimensional polyethylene wear of a press-fit titanium prosthesis. Factors influencing generation of polyethylene debris. J Arthroplasty. 1997; 12(3):256-66. DOI: 10.1016/s0883-5403(97)90021-8. View

20.

Sierra R, Schleck C, Cabanela M . Dislocation of bipolar hemiarthroplasty: rate, contributing factors, and outcome. Clin Orthop Relat Res. 2006; 442:230-8. DOI: 10.1097/01.blo.0000183741.96610.c3. View