Comparison of dual mobility total hip arthroplasty and bipolar arthroplasty for femoral neck fractures: A retrospective case-control study of 199 hips

Boukebous, Baptiste; Boutroux, Pierre; Zahi, Rédoine; Azmy, C.; Guillon, P.

doi:10.1016/j.otsr.2018.01.006

Cited by 59 publications

(24 citation statements)

References 22 publications

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“…Compared to bipolar hemiarthroplasty, total hip replacement is associated with high dislocation rate [[17], [18], [19], [20]]. Dual mobility THA is associated with reduced risk of dislocation without increasing the mortality [21].…”

Section: Discussionmentioning

confidence: 99%

Comparison of bipolar hemiarthroplasty and total hip arthroplasty with dual mobility cup in the treatment of old active patients with displaced neck of femur fracture: A retrospective cohort study

Fahad¹,

Khan²,

Aqueel³

et al. 2019

Annals of Medicine and Surgery

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Background The standard treatment of displaced femoral neck fracture is arthroplasty. THA is reportedly superior to BHA in terms of hip pain, function and reoperation rate. On the other hand THA has a higher rate of dislocation. Total hip replacement with dual mobility cup increases the range of motion and reduces the chances of dislocation. The aim of this study is to compare the functional outcome, rate of dislocation, complications and mortality between BHA and THA with dual mobility cuff for the treatment of displaced neck of femur fracture. Patients and method This is a non-commercialized retrospective cohort study conducted at our tertiary care level 1 trauma centre. Patients of age group 60 years and above who underwent hip arthroplasty (BHA or THA with dual mobility implant) between 2015 and 2017 for displaced neck of femur fracture with a complete follow up for one year were included. Both groups were assessed for postoperative surgical complications including dislocation, fracture, surgical site infection, and medical complications, one-year mortality and functional outcome were analysed via Harris Hip Score (HHS) at the latest follow up. Results Overall 104 patients were included in the study out of which 77 patients underwent BHA while 27 underwent THA with dual mobility cup. Baseline characteristics were found to be similar in both groups. Mean pre-op HHS for bipolar group was found to be 71.01 while for THA with dual mobility cup group it was 73.52 with the difference being statistically insignificant (P = 0.12). Mean post-op HHS for bipolar group was noted to be 68.82 whereas for THA with dual mobility cup group it was 76.81. The difference was found to be statistically significant with a P-value of <0.01. With regards to post-operative complications and one-year post-operative mortality, no significant difference was noted between both groups. Conclusion In relatively young and active elderly patients with displaced neck of femur fracture, a THA with dual mobility cuff provides better hip functional outcome, does not increase mortality or morbidity as compared to BHA and can be considered as primary treatment modality.

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Section: Discussionmentioning

confidence: 99%

Comparison of bipolar hemiarthroplasty and total hip arthroplasty with dual mobility cup in the treatment of old active patients with displaced neck of femur fracture: A retrospective cohort study

Fahad¹,

Khan²,

Aqueel³

et al. 2019

Annals of Medicine and Surgery

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“…Covariates adjusted for Ochi et al 36 Age, Sex, BMI, Operative side, Follow-up duration, Surgery duration, Preoperative blood loss, Intraoperative complications, dislocations, postoperative complications and reoperations Boukebous et al 37 Age, Gender, CCI Mean value, ADL Mean value, Dementia, Operative time, Transfusion, Stem used, Dislocation, Infection, Femur fracture, Thromboembolism, 1 year survival before adjustment and life threatening complications Kim et al 35 Age, BMI, Male, ASA classification Tabori-Jensen et al 40 Age, Gender, Oxford hip score 31 1 1 1 1 0 4 Homma et al 34 1 1 1 1 0 4 Hwang et al 42 0 0 1 1 0 2 Andersen et al 32 1 1 1 1 0 4 Adam et al 20 1 1 1 1 0 4 Tarasevicius et al 19 1 1 0 1 0 4 Tarasevicius et al 33 1 1 1 1 0 4 Ochi et al 36 1 1 0 1 1 4 Reshed et al 38 1 1 1 1 0 4 Boukebous et al 37 1 1 1 1 1 5 Kim et al 35 1 1 1 1 1 5 Zagorov et al 42 1 1 1 1 0 4 Assi et al 39 1 1 1 1 0 4 Tabori-Jensen et al 41 1 0 1 1 1 4 Tabori-Jensen et al 40 1 1 1 1 0 4…”

Section: Studymentioning

confidence: 99%

Outcomes of total hip arthroplasty using dual-mobility cups for femoral neck fractures: a systematic review and meta-analysis

et al. 2020

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Objectives: Femoral neck fractures (FNFs), with up to 15% mortality, are prominent orthopaedic emergencies. After treating FNFs, dislocation is another challenge increasing morbidity, mortality and treatment costs substantially. The emerging dual-mobility cup (DMC) may decrease dislocation rates following total hip arthroplasty (THA) for FNFs. We performed a systematic review of literature reporting dislocation and mortality rates with DMC-THA for the treatment of FNFs. Methods: 2 authors independently searched PubMed (MEDLINE), Google Scholar and Cochrane library for studies reporting dislocation and mortality rates for FNFs treated with DMC-THA since inception up to January 2019. Data on outcomes of interest was extracted from all studies and assessed for eligibility for a meta-analysis. Results: Out of 522 search results, 18 studies were included in the systematic review and 4 in the meta-analysis. The mean rate of dislocation following DMC-THA for FNFs was found to be 1.87% ± 2.11, with a 1-year mortality rate of 14.0% ± 10.55. Results of meta-analysis showed that dislocation and 1-year postoperative mortality rates were significantly lower for DMC-THA with a risk ratio 0.31 (95% CI, 0.16–0.59; I2 = 0%, p = 0.0003) and 0.55 (0.40, 0.77; I2 = 0%, p = 0.003) respectively when compared to biploar hemiathroplasty (BHA). Conclusions: The mean dislocation and mortality rates in DMC-THA are lower than previously reported rates for THA with single cup and comparable to unipolar and bipolar hemiarthroplasty. Further research involving randomised control trials to assess differences in outcomes, longevity and cost-effectiveness needs to be conducted to make recommendations for the use of DMC in treating FNFs.

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“…Femoral neck fractures (FNFs) in elderly individuals are associated with impaired mobility, loss of independence, and an overabundance of morbidity and mortality [ 1 – 3 ]. With the reversal of the ageing pyramid and the increasing prevalence of osteoporosis, FNFs remain a public health concern [ 3 – 5 ]. Treatment for FNFs remains challenging and controversial [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, few register-based studies have described long-term outcomes following CTR or UTR in individuals at a population-based level [ 3 , 7 ]. In addition, the features of high selectivity and a short length of follow-up are highly common in previous retrospective studies [ 5 , 10 ]. Consequently, the findings in these previous reports do not seem to reflect the actual situation.…”

Section: Introductionmentioning

confidence: 99%

Cemented versus uncemented total hip replacement for femoral neck fractures in elderly patients: a retrospective, multicentre study with a mean 5-year follow-up

et al. 2020

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Background Cemented or uncemented total hip replacement (CTR or UTR) for femoral neck fractures (AO/OTA type 31B/C) is a relatively common procedure in elderly individuals. The recent literature is limited regarding long-term outcomes following CTR versus UTR in the Asian population. Methods Using our institutional database, we performed long-term outcome analysis on 268 patients with femoral neck fractures (AO/OTA type 31B/C) who had undergone a primary UTR or CTR (CTR: n = 132, mean age, 67.43 ± 6.51 years; UTR: n = 136, mean age, 67.65 ± 6.13 years) during 2007–2014, and these patients were followed until 2019. Follow-up occurred 1, 3, 6, and 12 months postoperatively and yearly thereafter. The primary endpoint was the Harris hip score (HHS); the secondary endpoint was the incidence of orthopaedic complications. Results The mean follow-up time was 62.5 months (range, 50.1–76.1 months). At the final follow-up, the HHS was 79.39 ± 16.92 vs 74.18 ± 17.55 (CTR vs UTR, respectively, p = 0.011). Between-group significant differences were observed regarding the incidence of prosthesis revision, prosthesis loosening, and periprosthetic fracture (7.6% [95% CI, 6.4–8.2] for CTR vs 16.9% [95% CI, 14.7–17.3] for UTR, p = 0.020; 9.8% [95% CI, 8.3–10.7] for CTR vs 19.9% [95% CI, 18.2–20.9] for UTR, p = 0.022; 5.3% [95% CI, 4.4–6.7] for CTR vs 13.2% [95% CI, 12.1–13.8] for UTR, p = 0.026, respectively). Conclusion CTR showed superiority to UTR by improving the HHS and decreasing the incidence of orthopaedic complications. Our findings need to be confirmed in a prospective, randomized controlled study to verify whether they can be applicable to a broader population.

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Comparison of dual mobility total hip arthroplasty and bipolar arthroplasty for femoral neck fractures: A retrospective case-control study of 199 hips

Abstract: III, case-control study.

Cited by 59 publications

References 22 publications

Comparison of bipolar hemiarthroplasty and total hip arthroplasty with dual mobility cup in the treatment of old active patients with displaced neck of femur fracture: A retrospective cohort study

Comparison of bipolar hemiarthroplasty and total hip arthroplasty with dual mobility cup in the treatment of old active patients with displaced neck of femur fracture: A retrospective cohort study

Outcomes of total hip arthroplasty using dual-mobility cups for femoral neck fractures: a systematic review and meta-analysis

Cemented versus uncemented total hip replacement for femoral neck fractures in elderly patients: a retrospective, multicentre study with a mean 5-year follow-up

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