Dislocation rate, revisions and other complications of primary cemented hemiarthroplasty for displaced femoral neck fractures: a single-center cohort study of 743 unselected hips with a mean 2.7-year follow-up

Bue, Mats; Jakobsen, Stig Storgaard; Barckman, Jeppe; Tábori-Jensen, Steffan

doi:10.1007/s00402-021-04252-w

Cited by 2 publications

(4 citation statements)

References 25 publications

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“…The CPP approach in BHA for femoral neck fractures preserves the attachment of short external rotator muscles; the dislocation rate was reported as 0% [ 15 , 16 ]. There was one postoperative dislocation (0.6%) in the present study, and the dislocation rate was low compared to the previous reports of conversion posterior approach [ 3 , 4 , 5 , 6 , 7 , 8 ]. Improvement of daily living activities for patients and reduced caregiver burden was expected, especially for elderly patients.…”

Section: Discussioncontrasting

confidence: 74%

“…Furthermore, an obturator externus and a quadratus femoris were released as needed [ 22 ]. The dislocation rate with the posterior approach has been reported to be 3.8–13.0% [ 3 , 4 , 5 , 6 , 7 , 8 ]; the dislocation rate was lower with the repair of the joint capsule and external rotator muscles than without the repair [ 15 ]. However, once the capsule and short external rotator muscles are resected, the re-rupture rate is high (75–92%), even if being repaired [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative dislocation after BHA is a severe complication that compromises patients’ quality of life and mortality [ 2 ]. The dislocation rate with the posterior approach has been reported to be 3.8–13.0% [ 3 , 4 , 5 , 6 , 7 , 8 ], and the postoperative dislocation rate of the BHA with the posterior approach is higher than the anterior approach [ 7 , 9 , 10 ]. Several articles recommend against the use of the posterior approach because the risk of dislocation is eight times higher with the posterior approach than with the lateral approach, and the risk of recurrent dislocation is higher with the posterior approach [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures

Tanaka,

Mori,

Noro

et al. 2024

Medicina

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Background and Objectives: The conventional posterior approach in the lateral decubitus position is widely used for femoral neck fractures in femoral hemiarthroplasty. Postoperative dislocation is the major problem with this approach. The conjoined tendon-preserving posterior (CPP) approach is a less invasive surgical approach than the conventional posterior approach to the hip, maintains posterior stability, and preserves short external rotators and joint capsules. However, the mention was required to avoid muscle damage and whether muscle damage affects postoperative dislocation or not. The current study aimed to evaluate the clinical results of the CPP approach in hemiarthroplasty for femoral neck fractures and identify muscle damage risk factors. Materials and Methods: This study was a retrospective cohort study and included 170 hips in 168 patients. The mean age at the operation was 81.2 years. The preservation rate of the internal obturator muscle and gemellus inferior muscle and factors related to intraoperative short rotator muscle injury were investigated retrospectively. The postoperative complications and the relation between muscle damage and postoperative dislocation were investigated. Results: In the four hips (2.3%) with the obturator internus muscle damage, thirty-eight hips (22.4%) with gemellus inferior muscle damage were detected; in the muscle-damaged cases, the high body mass index (BMI) was significantly higher. The complication occurred in four hips (2.3%), including postoperative posterior dislocation in one hip without muscle damage (0.6%). Postoperative infection occurred in one hip (0.6%), and peroneal or sciatic nerve paralysis was suspected in two hips (1.1%). Conclusions: Compared to the conventional posterior approach in previous reports, the CPP approach reduces postoperative dislocation. A higher BMI is a risk factor for muscle damage, and the gemellus inferior muscle damage has no effect on postoperative dislocation. The CPP approach for BHA appeared to be an effective treatment method.

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures

Tanaka,

Mori,

Noro

et al. 2024

Medicina

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“…All patients in our study were treated using a posterolateral approach. In FNF patients treated with HA using the posterolateral approach, the incidence of dislocation is reported at 6.1–11.7% ( 28 , 29 ). Both populations have a high risk of dislocation and resemble each other in that FNF patients often have lower functional status and higher morbidity compared with osteoarthritic patients ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Dislocation rate after hip arthroplasty due to metastatic bone disease: a retrospective cohort study evaluating the postoperative dislocation risk across different articulating solutions

Iljazi

Sørensen

Hovgaard

et al. 2023

ActaO

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Background and purpose: Joint stability after hip replacement (HR) in patients with metastatic bone disease (MBD) is of special importance. Dislocation is the second leading cause of implant revision in HR, while survival after MBD surgery is poor with an expected 1-year survival of around 40%. As few studies have investigated the dislocation risk across different articulation solutions in MBD, we conducted a retrospective study on primary HR for patients with MBD treated in our department.Patients and methods: The primary outcome is the 1-year cumulative incidence of dislocation. We included patients with MBD who received HR at our department in 2003–2019. We excluded patients with partial pelvic reconstruction, total femoral replacement, and revision surgery. We assessed the incidence of dislocation with competing risk analysis with death and implant removal as competing risks.Results: We included 471 patients. Median follow-up was 6.5 months. The patients received 248 regular total hip arthroplasties (THAs), 117 hemiarthroplasties, 70 constrained liners, and 36 dual mobility liners. Major bone resection (MBR), defined as resection below the lesser trochanter, was performed in 63%. The overall 1-year cumulative incidence of dislocation was 6.2% (95% CI 4.0–8.3). Dislocation stratified by articulating surface was 6.9% (CI 3.7–10) for regular THA, 6.8% (CI 2.3–11) for hemiarthroplasty, 2.9% (CI 0.0–6.8) for constrained liner, and 5.6% (CI 0.0–13) for dual mobility liners. There was no significant difference between patients with and without MBR (p = 0.5).Conclusion: The 1-year cumulative incidence of dislocation is 6.2% in patients with MBD. Further studies are needed to determine any real benefits of specific articulations on the risk of postoperative dislocation in patients with MBD.

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Dislocation rate, revisions and other complications of primary cemented hemiarthroplasty for displaced femoral neck fractures: a single-center cohort study of 743 unselected hips with a mean 2.7-year follow-up

Cited by 2 publications

References 25 publications

Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures

Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures

Dislocation rate after hip arthroplasty due to metastatic bone disease: a retrospective cohort study evaluating the postoperative dislocation risk across different articulating solutions

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