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European Journal of Trauma and Emergency Surgery

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Open Access 30-03-2022 | Hip-TEP | Original Article

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

Authors: Johannes Karl Maria Fakler, Markus Rositzka, Nicolas Schopow, Andreas Roth, Dirk Zajonz, Mohamed Ghanem, Christian Kleber, Georg Osterhoff

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2022

Abstract

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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Title: 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
Authors: Johannes Karl Maria Fakler
Markus Rositzka
Nicolas Schopow
Andreas Roth
Dirk Zajonz
Mohamed Ghanem
Christian Kleber
Georg Osterhoff
Publication date: 30-03-2022
Publisher: Springer Berlin Heidelberg
Keywords: Hip-TEP
Hip-TEP
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-01918-x

At a glance: The STEP trials

Springer Medicine

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

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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