What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

Li, Lianhua; Ren, Jixin; Liu, Jia; Wang, Hao; Sang, Qing-Hua; Li, Zhi; Sun, Tiansheng

doi:10.1007/s11999-016-5053-3

Cited by 43 publications

(52 citation statements)

References 25 publications

(40 reference statements)

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“…Varley and Parker reported that dissociations accounted for 12% of all dislocations in bipolar prostheses [20]. Li L et al found that 15% of all dislocations also were dissociations [5]. The most common cause of early dissociation in the reports was manipulation for closed reduction after bipolar cup dislocation.…”

Section: Discussionmentioning

confidence: 99%

“…Yet, Sierra RJ et al reported there was no signi cant association of dislocation with the surgical approach [4]. A previous study reported that cognitive dysfunction was an independent risk factor associated with prosthetic dislocation [5]. Several studies suggested that decreasing femoral offset and limb-length shortening may reduce muscle tension and induce impingement between prosthesis and acetabulum, leading to dislocation [14,15].…”

Section: Discussionmentioning

confidence: 99%

“…Dislocation after primary BHA can usually be reduced by routine closed methods but is associated with a high rate of recurrent dislocation. Li L et al reported 54% of patients who had early dislocation sustained recurrent dislocations [5]. Similarly, Barnes CL et al report that 13 patients(52%) of these closed reduced hips subsequently experienced one or more re-dislocations, of which 7 required operative treatments for the recurrent dislocation [7].…”

Section: Introductionmentioning

confidence: 99%

“…BHA has some advantages over unipolar components; increased range of motion, variable choice of head size, neck length, decreased wear of acetabulum and reduced the risk of dislocation [3]. Therefore, BHA was widely used for elderly patients who experienced femoral neck fractures [4,5]. However, dislocation and dissociation can happen from the modularity of this implant.…”

Section: Introductionmentioning

confidence: 99%

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Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Fan¹,

Wang²,

Zhang³

et al. 2020

Preprint

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Background: Bipolar hemiarthroplasty (BHA) is one of the best options to treat femoral neck fracture in elderly patients. However, the early dislocation problem also happens in the bipolar cup. Furthermore, BHA has a specific implant-related complication, namely bipolar cup dissociation, in which the femoral head dissociates from the polyethylene (PE) liner. Early dislocation and dissociation are relatively uncommon but devastating complications and almost always lead to reoperation with revision of the prosthesis. Dislocation and dissociation of the bipolar cup can be challenging to manage and easily turn to recurrent episodes in case of improper handling. We hope to find out the best strategy for treatment early recurrent dislocation and dissociation of the bipolar cup.Methods: We retrospectively reviewed 2 patients who had a history of early recurrent posterior dislocations following primary BHA from 2016 to 2019. What’s more, they had early recurrent bipolar cup dissociation during the attempt of closed reduction maneuvers within 3 months of the original surgery.Results: All the patients were treated with open reduction and revision of Bipolar hemiarthroplasty (BHA). One patient has a good outcome, and no recurrence of dislocation was recorded.Conclusion: Recognition of the risk of dislocation and dissociation of bipolar cup is essential to its prevention and treatment. Complete revision of bipolar parts and the femoral head may be the minimum solution necessary to avoid the early recurrence of bipolar cup dissociation. Further investigations are recommended to strengthen these results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Fan¹,

Wang²,

Zhang³

et al. 2020

Preprint

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“…Instead, dislocation is because of patients’ lack of understanding, decreased response to pain, difficulties in communicating with doctors and an overall decline in walking ability [ 8 ]. In addition, it is sometimes difficult to maintain posture, both while sitting and standing, in cognitively impaired patients, which places the leg in an at-risk position for dislocation [ 13 ]. All three of our cases suffered from significant cognitive impairment, which played a role in their dislocations.…”

Section: Discussionmentioning

confidence: 99%

Hip Hemiarthroplasty in Neurologic or Cognitively Impaired Patients: A Case Series of Post-operative Dislocations

Piggott¹,

Smithwick²,

Murphy³

2018

JOCR

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Introduction: Hemiarthroplasty is the operation of choice for displaced intracapsular neck of femur fracture in elderly patients with low physical demands. Dislocation in this frail patient cohort can have devastating consequences. The patients with neurological and cognitive impairment are at additional risk secondary to imbalance of muscle tone and a reduced ability to engage with rehabilitation. Case Report: We present three cases of early post-operative dislocation of hip hemiarthroplasties, all of whom suffered from neurological and cognitive impairment, and highlight the uncontrollable patient factors that contributed to dislocation. Conclusion: The posterior approach was associated with all cases of dislocation in patients who also were neurologic or cognitively impaired. Posterior approach is safe to perform in the general population for hip hemiarthroplasty; however, the surgeon should consider avoiding the use of the posterior approach in this high-risk group. Keywords: Hemiarthroplasty, Dislocation, Elderly, Neurologic impairment, Cognitive impairment.

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Factors associated with dislocation after bipolar hemiarthroplasty through an (antero-)lateral approach in elderly patients with a femoral neck fracture: a retrospective cohort study with a nested case–control subanalysis of radiographic parameters

Fakler

Rositzka

Schopow

et al. 2022

Eur J Trauma Emerg Surg

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Introduction Dislocations of hip hemiarthroplasty (HHA) are serious complications. The aim of the study was to identify clinical aspects and radiographic parameters of the hip that put patients at risk for dislocation after HHA for femoral neck fractures. Methods This retrospective analysis included elderly patients with a femoral neck fracture treated with a HHA. A lateral (90.7%) and an anterolateral (9.3%) approach was applied. On pelvic radiographs, a nested-controlled analysis was performed. Two control patients were matched to one patient suffering a dislocation with respect to age, sex, and body-mass-index (BMI). Results In 527 HHA, 10 dislocations (1.9%) were identified. In the dislocation group (DG), all patients were female (100% vs. 73.5%, p = 0.071). No significant differences between the DG and the control group (CG) were found with respect to age, body-mass-index (BMI), ASA Score, routine laboratory parameters, and comorbidity. Radiographic analysis revealed a smaller center edge angle (CEA, 39.0, IQR 33.0–42.5 vs. 43.0, IQR 41.0–46.0, p = 0.013), a more varus neck-shaft angle (NSA, 130.0, IQR 125.8–133.5 vs. 135.0, IQR 134.0–137.0, p = 0.011) of the contralateral side and a higher femoral head extrusion index (FHEI) in the DG (FHEI, 11.5, IQR 9.8–16.3 vs. 2.0 IQR 0.0–9.0, p = 0.003). In addition, a greater trochanteric fracture was associated with an increased likelihood for HHA dislocations (30.0% vs 6.0%, p = 0.022). Conclusion A smaller radiographic center edge angle, a more varus neck-shaft angle of the contralateral side, a higher femoral head extrusion index and intraoperative fractures of the greater trochanter are associated with an increased risk of HHA dislocation.

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What Are the Risk Factors for Dislocation of Hip Bipolar Hemiarthroplasty Through the Anterolateral Approach? A Nested Case-control Study

Cited by 43 publications

References 25 publications

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Hip Hemiarthroplasty in Neurologic or Cognitively Impaired Patients: A Case Series of Post-operative Dislocations

Factors associated with dislocation after bipolar hemiarthroplasty through an (antero-)lateral approach in elderly patients with a femoral neck fracture: a retrospective cohort study with a nested case–control subanalysis of radiographic parameters

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