Dual mobility articulation total hip arthroplasty for displaced neck fracture in elderly with neuromuscular disorder |
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| Institution: | 1. Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Republic of Korea;2. Department of Orthopedic Surgery, Sungmin Hospital, Incheon, Republic of Korea;3. Department of Orthopedic Surgery, Gangnam Sacred Heart Hospital, Hallym University School of Medicine, Seoul, Republic of Korea;4. Department of Orthopedic Surgery, School of Medicine, Hanyang University, Seoul, Republic of Korea;5. Department of Orthopedic Surgery, Korea University College of Medicine, Guro Hospital, Seoul, Republic of Korea;1. Department of Radiology, Shandong Provincial Corps Hospital of Chinese People''s Armed Police Force, Jinan 250014, China;2. Department of Ultrasonography, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated to Shandong First Medical University, Jinan 250014, China;3. Department of Radiology, Affiliated Hospital of Binzhou Medical University, Binzhou 256600, China;1. R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA;2. Department of Surgery, Orthopaedics, USU-Walter Reed National Military Medical Center, Bethesda, Maryland, USA;3. R Adams Cowley Shock Trauma Center, Department of Infectious Disease, University of Maryland School of Medicine, Baltimore, Maryland, USA;4. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA;1. Sports Injury Center, Ring Road, Safdarjung Enclave, New Delhi 110029, India;2. Promhex Multispecialty Hospital, Omega 1, Greater Noida, Uttar Pradesh, India;3. Department of Orthopaedic Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, 13, Bahadur Shah Zafar Marg, New Delhi 110002, India;1. Department of Orthopaedics, HIMSR, New Delhi, India;2. Consultant Orthopaedics, Shalby Hospital, Surat, India;3. Department of Orthopaedics, HIMSR, New Delhi, India |
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| Abstract: | PurposeNeuromuscular disease is well known to be at increased risk of complications following hip replacement surgeries. This study is prospectively conducted to investigate clinical performance and survivorship of total hip arthroplasty (THA) using dual mobility articulation in femoral neck fractures of elderly with neuromuscular disease.Materials and MethodsWe prospectively enrolled 162 patients (162 hips) with displaced femoral neck fracture who gave informed consent for dual mobility articulation THA. Of the 162 patients, 35 patients had neuromuscular disease including cerebral palsy, poliomyelitis, hemiplegia, and Parkinson disease (NM group). The other 127 patients had no history of neuromuscular disease (non-NM group). The mean age was 76.5 years (range, 60 – 95) and female ratio was 71.0% (115/162). Clinical outcomes including Harris hip score (HHS), University of California Los Angles activity (UCLA) score were compared between the two groups. Computed tomography and serial radiographs were obtained after surgery. Postoperative complications and reoperation including revision were recorded.ResultsPain-VAS and all clinical scores of the NM group were comparable to those of the non-NM group. The incidence of dislocation in the NM group did not differ from that in Non-NM group (2/35, 5.7% versus 5/127, 3.9%, p = 0.645). Reoperation was performed in 3 hips (3/35, 8.6%) of the NM group and in 4 hips (4/127, 3.1%) of the non-NM group (p = 0.173). Kaplan-Meier survivorship with an end point of revision for any reason was 97.1% (95% confidence interval CI], 0.92 to 1.03) in the NM group and 98.4% (95% CI, 0.96 to 1.01) in the non-NM group at 7.3 years after surgery.ConclusionsIn elderly with neuromuscular disease, THA with dual mobility articulation is a reasonable option as a treatment for femoral neck fractures. |
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