149.
Dual mobility cup reduces the rate of dislocation compared to
hemiarthroplasty when used to treat displaced femoral neck fractures.
Anne Soon Bensen, Thomas Jakobsen, Mette Adler Stampe, Niels Krarup
Department of Orthopedic Surgery Regional Hospital Viborg; Department of
Orthopedic Surgery, Regional Hospital Viborg; Department of Orthopedic
Surgery, Regional Hospital Viborg; Department of Orthopedic Surgery,
Regional Hospital Viborg
Background:
Hemiarthroplasty (HA) is a well accepted treatment for
displaced femoral neck fractures. However dislocations are a frequent
complication. Total hip arthroplasty (THA) with a dual mobility cup (DMC)
are reported to lower the rate of dislocation in elective surgery but little is
known about the effect of THA with DMC when used to treat patients with
femoral neck fractures.
Purpose / Aim of Study:
The aim of this study is to compare rates of
dislocation and reoperation following treatment of displaced femoral neck
fractures with either a bipolar HA or a THA with DMC.
Materials and Methods:
The population of this study consists of 2
consecutive groups of patients who were treated for a displaced femoral neck
fracture with either a HA (171 patients) or a THA with DMC (177 patients) at
the Regional Hospital Viborg in the period from 01.01.2007 to 31.12.2010. In
2007-2008
the standard treatment at the Regional Hospital Viborg was HA. In
2009-2010
it was THA with DMC. Data regarding rates of dislocation and
reoperation were obtained by retrospective review of medical records.
Findings / Results:
We found a statistical significant difference regarding
rates of dislocation and reoperation in favor of THA. Rates of dislocation
within the first year were 14,6% (95%CI 9,3-19,9) for HA and 4,5% (95%CI
1,5-7,6)
for THA (p=0,0013). Rates of reoperation were 19,3% (95%CI 13-25)
for HA and 8,5% (95%CI 4,4-13) for THA (p=0,0034).
Conclusions:
Our results indicate that THA with DMC are superior to HA
when rates of dislocation and reoperation are compared. However further
RCT´s are necessary to determine the optimal treatment for displaced femoral
neck fractures.
