No abstract

At short term follow-up, the mean wear-rate in old and low demand patients was high, correlated to activity, and was above the generally accepted osteolysis threshold (0.1 mm/yr.). Cementless HA-coated cups had higher wear-rate than cemented cups.

AimsOur aim was to investigate function, health status and satisfaction in patients treated with primary dual mobility (DM) total hip arthroplasty (THA) after displaced femoral neck fracture (FNF).Patients and methodsFrom 2005–2011, 414 consecutive FNF patients received Saturne DM THA. At a minimum of 1-year follow-up, 124 (95 women) were evaluated with Oxford Hip Score (OHS), Harris Hip Score (HHS), health-related quality of life (HRQoL) measure (EQ-5D) and two functional tests: Timed Up and Go (TUG) and Sit to Stand 10 times (STS). The FNF patients were matched 1:2 by age, sex and surgery date with patients receiving THA due to osteoarthrosis (OA group) and 1-year OHS and EQ5D were compared. FNF patients were matched by age and sex with the general population index (GPI) for EQ-5D comparison.ResultsPatient age at surgery after FNF was mean 74.8 (range 30–92) years. At mean follow-up of 2.8 (range 1.0–7.7) years, mean EQ-5D score was 0.79 (SD 0.15) in the FNF group, which was similar to the matched GPI (p = 0.4), but lower (p = 0.014) compared to the OA group. Mean OHS was 36.4 (SD 9.5) in the FNF group and 38.4 (SD 7.2) in the OA group (p = 0.18). HHS in the FNF group was 78.7 (SD 15.5). Mean TUG time was 13.5 (SD 4.9) secs, and mean STS was 37.9 (SD 15.3) secs. Eighty nine percent (n = 111) of FNF patients were satisfied with the operation result.ConclusionDM THA following displaced FNF provides a good functional result and quality of life in addition to high patient satisfaction.

To evaluate the midterm performance of Boneloc cemented primary Exeter hip arthroplasty we examined the first 100 hips in 93 patients, who were alive at a median 56.6 (50–62) months after the operation. During the follow-up period 2 femoral stems and 2 acetabular cups were revised because of aseptic loosening from 3–5 years after the operation. A third acetabular cup was revised at the same time as a loose femoral stem, but was not found loose. The 5-year survival of both the stem and the cup was 98 per cent and for the surviving 98 hips the average Harris Hip Score was 87.6 (43–100) and the average pain score was 42.2 (10–44). Eighty nine per cent of patients were very satisfied or satisfied with their hip prosthesis and the patients’ own evaluations correlated well with the Harris Hip Scores. Follow-up radiographs revealed definite loosening of 3 stems and 2 cups, probably loosening of one stem and 2 cups, and possibly loosening of 2 stems and one cup. The Exeter stem subsided significantly within the cement mantle by median 3.3 (0–19) mm. In a subgroup of patients subsidence diminished significantly from the first 28 months compared to the last 31 months. Subsidence at the cement bone interface was only seen in 4 hips, where cement fractures had developed. Poor quality cementation, and valgus position of the femoral stem, significantly increased the risk of aseptic loosening, as did osteolysis and cement fracture. Poor cementing technique and continuous radiolucent lines at follow-up radiographs were positively correlated with acetabular cup loosening. The rather good midterm results with the Exeter femoral stem can probably be ascribed to the collarless, polished, double tapered stem design.

At short term follow-up, the mean wear-rate in old and low demand patients was high, correlated to activity, and was above the generally accepted osteolysis threshold (0.1 mm/yr.). Cementless HA-coated cups had higher wear-rate than cemented cups.