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International Orthopaedics
Published in: International Orthopaedics 7/2015

01-07-2015 | Original Paper

Dislocation of bipolar hip hemiarthroplasty through a postero-lateral approach for femoral neck fractures: A cohort study

Authors: Sebastian Mukka, Jenny Lindqvist, Sara Peyda, Cyrus Brodén, Sarwar Mahmood, Hamid Hassany, Arkan Sayed-Noor

Published in: International Orthopaedics | Issue 7/2015

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Abstract

Purpose

To analyze postoperative global femoral offset (FO), leg length discrepancy (LLD) and Wiberg angle as risk factors for prosthetic dislocation after treatment with bipolar hemiarthoplasty (HA) through a postero-lateral approach for femoral neck fracture (FNF).

Methods

Three hundred and seventy three patients treated with a cemented bipolar HA through a postero-lateral approach between January 2006 and December 2013 were included in a cohort study with a follow-up time ranging from 6 months to 7 years. Radiographs and all surgical records were reviewed regarding Global FO, LLD and Wiberg angle. We compared stable hips without dislocation to those with either a single dislocation and those with recurrent instability.

Results

Three hundred and twenty eight hips fulfilled the inclusion criteria and were analyzed in the study. The incidence of prosthetic dislocation was 10.7 % (36/373). The mean time from surgery to first dislocation was 3.9 months (0-47) and 62.5 % had recurrent dislocations. Patients with dislocation had a statistically significantly decreased postoperative global FO (-6.4 mm vs. -2.8 mm, p = 0.04), LLD (-2 vs. 1.5 mm, p = 0.03) and smaller Wiberg angle (40° vs. 46°, p = 0.01) on the operated side compared with the rest of cohort. In comparison to age and sex-matched control groups from the cohort, the difference in the radiographic parameters were significant in patients with recurrent dislocations but not in patients with a single dislocation.

Conclusion

Patients with recurrent dislocations had a decreased postoperative global FO, shorter leg and shallower acetabulum on the operated side compared with their controls. These factors might decrease the soft-tissue tension around the operated hip and predispose to dislocation.

Level of Evidence

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Metadata
Title
Dislocation of bipolar hip hemiarthroplasty through a postero-lateral approach for femoral neck fractures: A cohort study
Authors
Sebastian Mukka
Jenny Lindqvist
Sara Peyda
Cyrus Brodén
Sarwar Mahmood
Hamid Hassany
Arkan Sayed-Noor
Publication date
01-07-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 7/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2642-1

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