Iker Uriarte1, Jesús Moreta2, Iñigo Jimenez3, María José Legarreta4, José Luis Martínez de Los Mozos3. 1. Department of Orthopedic Surgery and Trauma, Hospital Galdakao-Usansolo, Bizkaia, Spain; Lower Limb Reconstruction Group. Biocruces Bizkaia Health Research Institute, Hospital Galdakao-Usansolo. Osakidetza, Bizkaia, Spain. Electronic address: txuriart@hotmail.com. 2. Department of Orthopedic Surgery and Trauma, Hospital Galdakao-Usansolo, Bizkaia, Spain; Lower Limb Reconstruction Group. Biocruces Bizkaia Health Research Institute, Hospital Galdakao-Usansolo. Osakidetza, Bizkaia, Spain. 3. Department of Orthopedic Surgery and Trauma, Hospital Galdakao-Usansolo, Bizkaia, Spain. 4. Research Unit, Hospital Galdakao-Usansolo (Bizkaia, Spain). Health Services Research on Chronic Diseases Network, REDISSEC.
Abstract
INTRODUCTION: Total hip arthroplasty (THA) after femoral neck fracture (FNF) is associated with an increased risk of dislocation. The goals of our study were (1) to determine dislocation and revision rates when dual-mobility cups (DMCs) are used in these patients, (2) to analyze clinical and radiographic outcomes, survivorship, complications and mortality rate, and (3) to compare results between cemented and cementless cups. PATIENTS AND METHODS: We retrospectively reviewed patients with FNF treated using DMC-THA between 2011 and 2018. A minimum 2-year follow-up was required for clinical and radiographic assessment. The clinical outcome was assessed using the Harris Hip Score (HHS) and Merlé D´Aubigné-Postel score (MDP). Radiolucent lines, osteolysis and cup loosening were analyzed. RESULTS: We included 105 patients (105 hips) with a mean age of 75.5 years. There were no dislocations. One patient (1.0%) underwent cup revision at 39 months for aseptic cup loosening. The mean HHS and MDP were 80.5 and 14.2 respectively at a mean follow-up of 4.1 years. A higher MDP was found in patients with cementless rather than cemented cups (15.0 vs. 13.1; p = 0.006). Four patients had radiolucent lines > 1 mm, around cemented cups. At 6.8 years, estimated cup survival was 98.2% for revision for aseptic loosening and 97.3% for revision for any reason. The mortality rates were 6.7% at 1 year and 23.8% at last follow-up. CONCLUSION: Our findings suggest that using DMC in THA for FNF may prevent dislocation with a low revision rate. Cementless cups had a higher MDP than cemented cups.
INTRODUCTION: Total hip arthroplasty (THA) after femoral neck fracture (FNF) is associated with an increased risk of dislocation. The goals of our study were (1) to determine dislocation and revision rates when dual-mobility cups (DMCs) are used in these patients, (2) to analyze clinical and radiographic outcomes, survivorship, complications and mortality rate, and (3) to compare results between cemented and cementless cups. PATIENTS AND METHODS: We retrospectively reviewed patients with FNF treated using DMC-THA between 2011 and 2018. A minimum 2-year follow-up was required for clinical and radiographic assessment. The clinical outcome was assessed using the Harris Hip Score (HHS) and Merlé D´Aubigné-Postel score (MDP). Radiolucent lines, osteolysis and cup loosening were analyzed. RESULTS: We included 105 patients (105 hips) with a mean age of 75.5 years. There were no dislocations. One patient (1.0%) underwent cup revision at 39 months for aseptic cup loosening. The mean HHS and MDP were 80.5 and 14.2 respectively at a mean follow-up of 4.1 years. A higher MDP was found in patients with cementless rather than cemented cups (15.0 vs. 13.1; p = 0.006). Four patients had radiolucent lines > 1 mm, around cemented cups. At 6.8 years, estimated cup survival was 98.2% for revision for aseptic loosening and 97.3% for revision for any reason. The mortality rates were 6.7% at 1 year and 23.8% at last follow-up. CONCLUSION: Our findings suggest that using DMC in THA for FNF may prevent dislocation with a low revision rate. Cementless cups had a higher MDP than cemented cups.