Morphological risk factors associated with dislocation after bipolar hemiarthroplasty of the hip in patients with femoral neck fractures—a nested case-control study

Zhang, Yueqi; Yao, Zhenjun; Shi, Peng; Wang, Chenzhong; Liu, Jinyu; Yang, Yi; Zhang, Chi

doi:10.1186/s13018-019-1409-1

Cited by 16 publications

(24 citation statements)

References 24 publications

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“…Decreased CE angle was associated with a shallower and more vertical acetabulum, leading high risk of dislocation. Similarly, Zhang et al 14 reported that HA patients with a CE angle ≤45.4°or an acetabular depth ≤ 19.12 mm were more likely to suffer dislocation. A Korean study also pointed that defining dislocation as the existence of a CE angle >44°had a sensitivity of 81.3% and a specificity of 76.0% in hemiarthroplasty.…”

Section: Discussionmentioning

confidence: 90%

“…8,11 Several studies have identified risk factors for dislocation in patients after undergoing hip HA. [12][13][14] However, conclusive evidence is rare and some studies have presented contradicting results. Generally, risk factors were classified into patient factors, surgical factors, and morphological factors.…”

Section: Introductionmentioning

confidence: 99%

“…15 Morphological factors including femoral head size, femoral offset, leg-length discrepancy, acetabular center edge (CE) angle and coverage ratio have been identified as potential factors affecting the dislocation rates. [13][14][15][16] However, a systematic and comprehensive evaluation was not performed. Dissociation, as a special type of dislocation, is defined as the separation of bipolar components during dislocation.…”

Section: Introductionmentioning

confidence: 99%

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Multivariable Analysis of Risk Factors Affecting Dislocation After Bipolar Hemiarthroplasty in Patients with Femoral Neck Fracture

Yang

et al. 2022

TCRM

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This study aimed to investigate the risk factors associated with dislocation and dissociation following bipolar hemiarthroplasty (HA) for the treatment of patients with femoral neck fractures. Methods: We retrospectively reviewed 462 patients (479 hips) treated with bipolar HA from January 2010 to January 2020. All patients received posterolateral approaches and a minimum follow-up of at least 2 years regularly. A case-control study was performed to analyze the risk factors of dislocation regarding patient demographics, coexisting diseases, surgical and morphologic features. Multivariable logistic regression analysis for independent risk factors affecting dislocation and dissociation was also performed. Results: The dislocation rate was 5.01%, and the mean time from HA to the first incident of dislocation was 38.75 days. Patientrelated factors, including operation side, prosthesis type, and neuromuscular disease, did not differ significantly. Regarding the morphological factors, a significant difference was observed in center-edge (CE) angle, abduction angle, acetabular depth, depth/ width ratio, rotation center (RC) to greater trochanter tip (GTT) vertical distance, RC to GTT vertical distance difference, RC to GTT horizontal distance, RC to GTT horizontal distance difference, offset difference, and offset discrepancy. Further, decreased CE angle, increased abduction angle, decreased RC to GTT vertical distance, decreased offset difference and increased offset discrepancy were determined to be independent risk factors of dislocation. The proportion of patients experiencing dissociation was 1.04%. All the implanted femoral heads were smaller than 43 mm, which was determined to be the risk factor of dissociation. Conclusion: Decreased CE angle, RC to GTT vertical distance, offset difference, and increased abduction angle, offset discrepancy were determined to be independent risk factors of HA dislocation. Once dislocation risk was detected by simulated templating, THA or changing surgical approach should be considered to avoid evitable perioperative complications.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Multivariable Analysis of Risk Factors Affecting Dislocation After Bipolar Hemiarthroplasty in Patients with Femoral Neck Fracture

Yang

et al. 2022

TCRM

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“…Previous studies have stated that the incidence of dislocation is related to the small acetabular depth and small acetabular depth-width ratio. The elderly patients with a center-edge angle of ≤ 45.4° (p < 0.001) or an acetabular depth of ≤ 19.12 mm (p< 0.001) were susceptible to experience dislocation after BHA [7]. A comprehensive review by Jones et al explained several factors related to HA dislocation, including patient cognition, preceding surgery failure, delay to surgery, types of surgical approach, and the femoral offset [8].…”

Section: Discussionmentioning

confidence: 99%

Dislocation After Bipolar Hemiarthroplasty in Elderly Patient: A Case Report

Dharmayuda

Febyan²

2021

EJMED

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Total hip arthroplasty and hemiarthroplasty are two primary treatment choices for elderly patients with fractures or dislocations of the pelvic bone, as well as in fractures of the femoral neck. Dislocation of bipolar hemiarthroplasty is a rare postsurgical complication, but it can be a problem that requires acute management and is quite challenging to revise. We presented a case of an elderly patient with dislocation of hip bipolar hemiarthroplasty on the right side. The patient underwent a revision of total hip arthroplasty and had a satisfactory outcome. Mobilization began within two days after surgery. One-year follow-up revealed no occurrence of long-term complications.

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“…Some authors maintain that patients with smaller lateral centre-edge angle (LCEA) and smaller acetabular depth are more likely to suffer this complication. 17 –20 Further, an offset discrepancy seems to be a known and accepted risk factor for dislocation. 13,19…”

Section: Introductionmentioning

confidence: 99%

Should we employ preoperative templating in hip hemiarthroplasty after femoral neck fracture? A nested case-control study

et al. 2020

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Introduction: Dislocation following hip hemiarthroplasty is a serious complication. It remains unclear if acetabular morphology is associated with a higher risk of dislocation. The aim of our study was to investigate whether there are differences in hip morphology radiological parameters between patients who have suffered a dislocation episode, and those who have not suffered a dislocation. Material and methods: Between January 2015 and December 2018, a nested case-control study was performed. From 707 patients who underwent hip hemiarthroplasty because of femoral neck fracture, 50 patients (50 hips) suffered an episode of dislocation. They were randomly matched with 94 patients (100 hips) without dislocation (ratio 1:2). Clinical data regarding demographics, medical comorbidities and surgical and radiological parameters were studied. Results: Statistically significantly smaller lateral centre-edge angle (LCEA) and femoral offset (FO) and greater Tönnis angle were found in the dislocation group. No differences in acetabular angle were seen. Neurological impairment prevalence was statistically significantly higher in patients who suffered a dislocation (60% vs. 44%, p = 0.011). Conclusions: The current study suggests that a smaller LCEA and FO, a greater TA, and neurological impairment could be related to a higher risk of hip hemiarthroplasty dislocation after femoral neck fracture in the elderly. We consider that preoperative templating could be helpful in identifying abnormal parameters and carefully planning surgery could lead to changes in treatment strategy, such as choosing a dual-mobility total hip arthroplasty.

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Morphological risk factors associated with dislocation after bipolar hemiarthroplasty of the hip in patients with femoral neck fractures—a nested case-control study

Cited by 16 publications

References 24 publications

Multivariable Analysis of Risk Factors Affecting Dislocation After Bipolar Hemiarthroplasty in Patients with Femoral Neck Fracture

Multivariable Analysis of Risk Factors Affecting Dislocation After Bipolar Hemiarthroplasty in Patients with Femoral Neck Fracture

Dislocation After Bipolar Hemiarthroplasty in Elderly Patient: A Case Report

Should we employ preoperative templating in hip hemiarthroplasty after femoral neck fracture? A nested case-control study

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