Abstract | INTRODUCTION: The choice of implant type for total hip replacement in the treatment of femoral neck fractures remains debated. Some authors advocate for the systematic use of cemented stems, while others do not use dual mobility first-line. We therefore conducted a retrospective study using a dual mobility cup (DMC) and an uncemented collared stem (UCS) in order to: (1) confirm the low dislocation rate in this indication, (2) assess other surgical complications, in particular periprosthetic fractures, (3) ensure that these benefits are maintained over time, at a minimum follow-up of 5 years and, (4) assess the rate of revision of the implants. HYPOTHESIS: PATIENTS AND METHODS: A retrospective study of 244 femoral neck fractures (242 patients) treated with DMC and UCS was conducted, between 2013 and 2014. The mean age was 83±10 years (60-104). The occurrence of dislocation, periprosthetic fracture, infection of the surgical site, loosening, reoperation and revision were investigated. The HOOS Joint Replacement (JR) score was collected. The cumulative incidence with mortality was used as a competing risk. RESULTS: The mean follow-up was 6 years±0.5 (5-7). At the last follow-up, 108 patients (50%) had died. Twenty-three patients (9.5%) were lost to follow-up. One case of symptomatic aseptic loosening of DMC was observed. The cumulative incidence of dislocations and periprosthetic fractures at 5 years were 2% (95% CI: 0.9-5.4) and 3% (95% CI: 1.2-6), respectively. The 5-year cumulative incidence of surgical site infections was 3.5% (95% CI: 1.8-7). The cumulative incidence of reoperations at 5 years was 7% (95% CI: 4.5-11). The causes of reoperation were periprosthetic fracture (n=6), infection (n=8), postoperative hematoma (n=2) and cup malposition (n=2). The cumulative incidence of a revision at 5 years was 2.7% (95% CI: 1.2-6). The cumulative incidence of a surgical complication from any cause at 5 years was 9% (95% CI: 6.7-14.8). The mean HOOS JR score was 79±5 (52-92). DISCUSSION: LEVEL OF EVIDENCE: IV; retrospective study without control group.
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Authors | Maxence Bordes, Anthony Viste, Mathieu Fauvernier, Marcelle Mercier, Philippe Chaudier, Mathieu Severyns, Michel-Henri Fessy |
Journal | Orthopaedics & traumatology, surgery & research : OTSR
(Orthop Traumatol Surg Res)
Vol. 108
Issue 1
Pg. 103164
(02 2022)
ISSN: 1877-0568 [Electronic] France |
PMID | 34863956
(Publication Type: Journal Article)
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Copyright | Copyright © 2021 Elsevier Masson SAS. All rights reserved. |
Topics |
- Aged
- Aged, 80 and over
- Arthroplasty, Replacement, Hip
(adverse effects)
- Femoral Neck Fractures
(etiology, surgery)
- Follow-Up Studies
- Hip Prosthesis
(adverse effects)
- Humans
- Periprosthetic Fractures
(etiology, surgery)
- Prosthesis Design
- Prosthesis Failure
- Reoperation
- Retrospective Studies
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