Total, hemi, or dual-mobility arthroplasty for the treatment of femoral neck fractures in patients with neurological disease ANALYSIS OF 9,638 PATIENTS FROM THE SWEDISH HIP ARTHROPLASTY REGISTER

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Cnudde, Peter,1970Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics (författare)

Total, hemi, or dual-mobility arthroplasty for the treatment of femoral neck fractures in patients with neurological disease ANALYSIS OF 9,638 PATIENTS FROM THE SWEDISH HIP ARTHROPLASTY REGISTER

Artikel/kapitelEngelska2022

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2022

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LIBRIS-ID:oai:gup.ub.gu.se/317002
https://gup.ub.gu.se/publication/317002URI
https://doi.org/10.1302/0301-620x.104b1.Bjj-2021-0855.R1DOI

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Språk:engelska

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Aims The aim of this study was to investigate the potentially increased risk of dislocation in patients with neurological disease who sustain a femoral neck fracture, as it is unclear whether they should undergo total hip arthroplasty (THA) or hemiarthroplasty (HA). A secondary aim was to investgate whether dual-mobility components confer a reduced risk of dislocation in these patients. Methods We undertook a longitudinal cohort study linking the Swedish Hip Arthroplasty Register with the National Patient Register, including patients with a neurological disease presenting with a femoral neck fracture and treated with HA, a conventional THA (cTHA) with femoral head size of <= 32 mm, or a dual-mobility component THA (DMC-THA) between 2005 and 2014. The dislocation rate at one- and three-year revision, reoperation, and mortality rates were recorded. Cox multivariate regression models were fitted to calculate adjusted hazard ratios (HRs). Results A total of 9,638 patients with a neurological disease who also underwent unilateral arthroplasty for a femoral neck fracture were included in the study. The one-year dislocation rate was 3.7% after HA, 8.8% after cTHA < 32 mm), 5.9% after cTHA (= 32 mm), and 2.7% after DMC-THA. A higher risk of dislocation was associated with cTHA (< 32 mm) compared with HA (HR 1.90 (95% confidence interval (CI) 1.26 to 2.86); p = 0.002). There was no difference in the risk of dislocation with DMC-THA (HR 0.68 (95% CI 0.26 to 1.84); p = 0.451) or cTHA (= 32 mm) (HR 1.54 (95% CI 0.94 to 2.51); p = 0.083). There were no differences in the rate of reoperation and revision-free survival between the different types of prosthesis and sizes of femoral head. Conclusion Patients with a neurological disease who sustain a femoral neck fracture have similar rates of dislocation after undergoing HA or DMC-THA. Most patients with a neurological disease are not eligible for THA and should thus undergo HA, whereas those eligible for THA could benefit from a DMC-THA.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Ortopedi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Orthopaedics hsv//eng
dislocation rates
head size
risk
hemiarthroplasty
outcomes
revision
tha
reoperation
replacement
cohort
Orthopedics
Surgery

Biuppslag (personer, institutioner, konferenser, titlar ...)

Natman, J. (författare)
Hailer, N. P. (författare)
Rogmark, C. (författare)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för ortopedi (creator_code:org_t)

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Ingår i:Bone & Joint Journal104B:1, s. 134-1412049-4394

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Av författaren/redakt...: Cnudde, Peter, 1 ...; Natman, J.; Hailer, N. P.; Rogmark, C.

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Ortopedi

Artiklar i publikationen: Bone & Joint Jou ...

Av lärosätet: Göteborgs universitet

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