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.
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.
Authors: John E Farey; James Masters; Alana R Cuthbert; Pernille Iversen; Liza N van Steenbergen; Heather A Prentice; Sam Adie; Adrian Sayers; Michael R Whitehouse; Elizabeth W Paxton; Matthew L Costa; Søren Overgaard; Cecilia Rogmark; Ola Rolfson; Ian A Harris Journal: Clin Orthop Relat Res Date: 2022-06-16 Impact factor: 4.755
Authors: Erik Zachwieja; Alexander J Butler; Luis C Grau; Spencer Summers; Dustin Massel; Fabio Orozco; Victor H Hernandez Journal: J Clin Orthop Trauma Date: 2019-01-03
Authors: Wayne Hoskins; Xavier Griffin; Alesha Hatton; Richard N de Steiger; Roger Bingham Journal: Clin Orthop Relat Res Date: 2021-01-01 Impact factor: 4.755