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Erschienen in: International Orthopaedics 6/2014

01.06.2014 | Original Paper

Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures

verfasst von: Anne S. Bensen, Thomas Jakobsen, Niels Krarup

Erschienen in: International Orthopaedics | Ausgabe 6/2014

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Abstract

Purpose

Total hip arthroplasty (THA) as primary treatment for displaced femoral neck fractures is controversial as THA is associated with higher rates of dislocation but lower rates of re-operation compared to hemiarthroplasty (HA). A dual mobility cup (DMC) design is associated with lower dislocation and re-operation rates in elective surgery. Is this also the case when used to treat displaced femoral neck fractures? The aim of this study is to compare rates of dislocation and re-operation of any kind following treatment for displaced femoral neck fractures with either bipolar HA or THA with DMC.

Methods

Two consecutive groups of patients treated for displaced femoral neck fractures at the Regional Hospital in Viborg in Denmark were included. In 2007–2008 171 patients (mean age 84.1 years) were treated with bipolar HA. In 2009–2010 175 patients (mean age 75.2 years) were treated with THA with DMC. Data regarding rates of dislocation and re-operation were obtained by retrospective review of medical records.

Results

We found a statistically significant difference regarding rates of dislocation and re-operation of any kind in favour of THA with DMC. Dislocation occurred in 25/171 patients [95 % confidence interval (CI) 9.3–19.9 %] treated with bipolar HA and 8/175 patients (95 % CI 1.5–7.7 %) treated with THA with DMC (p = 0.002). Re-operations were required in 32/171 patients (95 % CI 12.9–24.6 %) treated with bipolar HA and 16/175 patients (95 % CI 4.8–13.4 %) treated with THA with DMC (p = 0.01).

Conclusions

Our findings indicate that THA with DMC is superior to bipolar HA following treatment for displaced femoral neck fractures in regard to rates of dislocation and re-operation.
Literatur
1.
Zurück zum Zitat Riggs BL, Melton LJ III (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17(5 Suppl):505S–511SPubMedCrossRef Riggs BL, Melton LJ III (1995) The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 17(5 Suppl):505S–511SPubMedCrossRef
2.
Zurück zum Zitat Parker MJ, Gurusamy KS, Azegami S (2010) Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev 6:CD001706PubMed Parker MJ, Gurusamy KS, Azegami S (2010) Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev 6:CD001706PubMed
3.
Zurück zum Zitat Burgers PT, Van Geene AR, Van den Bekerom MP, Van Lieshout EM, Blom B, Aleem IS, Bhandari M, Poolman RW (2012) 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 36(8):1549–1560PubMedCentralPubMedCrossRef Burgers PT, Van Geene AR, Van den Bekerom MP, Van Lieshout EM, Blom B, Aleem IS, Bhandari M, Poolman RW (2012) 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 36(8):1549–1560PubMedCentralPubMedCrossRef
4.
Zurück zum Zitat Liao L, Zhao Jm, Su W, Ding Xf, Chen Lj, Luo Sx (2012) A meta-analysis of total hip arthroplasty and hemiarthroplasty outcomes for displaced femoral neck fractures. Arch Orthop Trauma Surg 132(7):1021–1029PubMedCrossRef Liao L, Zhao Jm, Su W, Ding Xf, Chen Lj, Luo Sx (2012) A meta-analysis of total hip arthroplasty and hemiarthroplasty outcomes for displaced femoral neck fractures. Arch Orthop Trauma Surg 132(7):1021–1029PubMedCrossRef
5.
Zurück zum Zitat Yu L, Wang Y, Chen J (2012) Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures: meta-analysis of randomized trials. Clin Orthop Relat Res 470(8):2235–2243PubMedCentralPubMedCrossRef Yu L, Wang Y, Chen J (2012) Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures: meta-analysis of randomized trials. Clin Orthop Relat Res 470(8):2235–2243PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Hopley C, Stengel D, Ekkernkamp A, Wich M (2010) Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ 340:c2332PubMedCrossRef Hopley C, Stengel D, Ekkernkamp A, Wich M (2010) Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ 340:c2332PubMedCrossRef
7.
Zurück zum Zitat Macaulay W, Nellans KW, Garvin KL, Iorio R, Healy WL, Rosenwasser MP, other members of the DFACTO Consortium (2008) Prospective randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty in the treatment of displaced femoral neck fractures. J Arthroplasty 23(6 Suppl 1):2–8PubMedCrossRef Macaulay W, Nellans KW, Garvin KL, Iorio R, Healy WL, Rosenwasser MP, other members of the DFACTO Consortium (2008) Prospective randomized clinical trial comparing hemiarthroplasty to total hip arthroplasty in the treatment of displaced femoral neck fractures. J Arthroplasty 23(6 Suppl 1):2–8PubMedCrossRef
8.
Zurück zum Zitat Carroll C, Stevenson M, Scope A, Evans P, Buckley S (2011) Hemiarthroplasty and total hip arthroplasty for treating primary intracapsular fracture of the hip: a systematic review and cost-effectiveness analysis. Health Technol Assess 15(36):1–74 Carroll C, Stevenson M, Scope A, Evans P, Buckley S (2011) Hemiarthroplasty and total hip arthroplasty for treating primary intracapsular fracture of the hip: a systematic review and cost-effectiveness analysis. Health Technol Assess 15(36):1–74
10.
Zurück zum Zitat Stroh A, Naziri Q, Johnson AJ, Mont MA (2012) Dual-mobility bearings: a review of the literature. Expert Rev Med Devices 9(1):23–31PubMedCrossRef Stroh A, Naziri Q, Johnson AJ, Mont MA (2012) Dual-mobility bearings: a review of the literature. Expert Rev Med Devices 9(1):23–31PubMedCrossRef
11.
Zurück zum Zitat Adam P, Philippe R, Ehlinger M, Roche O, Bonnomet F, Molé D, Fessy MH, French Society of Orthopaedic Surgery and Traumatology (SoFCOT) (2012) 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 98(3):296–300PubMedCrossRef Adam P, Philippe R, Ehlinger M, Roche O, Bonnomet F, Molé D, Fessy MH, French Society of Orthopaedic Surgery and Traumatology (SoFCOT) (2012) 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 98(3):296–300PubMedCrossRef
12.
Zurück zum Zitat Tarasevicius S, Busevicius M, Robertsson O, Wingstrand H (2010) Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture. BMC Musculoskelet Disord 11:175PubMedCentralPubMedCrossRef Tarasevicius S, Busevicius M, Robertsson O, Wingstrand H (2010) Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture. BMC Musculoskelet Disord 11:175PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Taylor F, Wright M, Zhu M (2012) Hemiarthroplasty of the hip with and without cement: a randomized clinical trial. J Bone Joint Surg Am 94(7):577–583PubMed Taylor F, Wright M, Zhu M (2012) Hemiarthroplasty of the hip with and without cement: a randomized clinical trial. J Bone Joint Surg Am 94(7):577–583PubMed
14.
Zurück zum Zitat Foster AP, Thompson NW, Wong J, Charlwood AP (2005) Periprosthetic femoral fractures–a comparison between cemented and uncemented hemiarthroplasties. Injury 36(3):424–429PubMedCrossRef Foster AP, Thompson NW, Wong J, Charlwood AP (2005) Periprosthetic femoral fractures–a comparison between cemented and uncemented hemiarthroplasties. Injury 36(3):424–429PubMedCrossRef
15.
Zurück zum Zitat Wu CC, Au MK, Wu SS, Lin LC (1999) Risk factors for postoperative femoral fracture in cementless hip arthroplasty. J Formos Med Assoc 98(3):190–194PubMed Wu CC, Au MK, Wu SS, Lin LC (1999) Risk factors for postoperative femoral fracture in cementless hip arthroplasty. J Formos Med Assoc 98(3):190–194PubMed
16.
Zurück zum Zitat van der Wal BC, Vischjager M, Grimm B, Heyligers IC, Tonino AJ (2005) Periprosthetic fractures around cementless hydroxyapatite-coated femoral stems. Int Orthop 29(4):235–240PubMedCentralPubMedCrossRef van der Wal BC, Vischjager M, Grimm B, Heyligers IC, Tonino AJ (2005) Periprosthetic fractures around cementless hydroxyapatite-coated femoral stems. Int Orthop 29(4):235–240PubMedCentralPubMedCrossRef
17.
Zurück zum Zitat Johansson T, Jacobsson SA, Ivarsson I, Knutsson A, Wahlström O (2000) Internal fixation versus total hip arthroplasty in the treatment of displaced femoral neck fractures: a prospective randomized study of 100 hips. Acta Orthop Scand 71(6):597–602PubMedCrossRef Johansson T, Jacobsson SA, Ivarsson I, Knutsson A, Wahlström O (2000) Internal fixation versus total hip arthroplasty in the treatment of displaced femoral neck fractures: a prospective randomized study of 100 hips. Acta Orthop Scand 71(6):597–602PubMedCrossRef
Metadaten
Titel
Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures
verfasst von
Anne S. Bensen
Thomas Jakobsen
Niels Krarup
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 6/2014
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2276-8

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