1. Dual Mobility hip replacement in hip fractures offer functional equivalence and a stability advantage - A case-controlled study
- Author
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S.A. Sexton, Olutunmise J Ashaye, Tal D Ellenbogen, Rory G Middleton, and Christian Eb Gray Stephens
- Subjects
Reoperation ,musculoskeletal diseases ,medicine.medical_specialty ,Arthroplasty, Replacement, Hip ,medicine.medical_treatment ,Oxford hip score ,Prosthesis Design ,Prosthesis ,Hip replacement (animal) ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,medicine ,Performed Procedure ,Hip Dislocation ,Humans ,Aged ,Retrospective Studies ,General Environmental Science ,030222 orthopedics ,Hip fracture ,Hip Fractures ,business.industry ,Case-control study ,030208 emergency & critical care medicine ,medicine.disease ,Dual mobility ,Prosthesis Failure ,surgical procedures, operative ,Physical therapy ,General Earth and Planetary Sciences ,Hip Prosthesis ,business - Abstract
Background Hip fracture is a common and serious injury in the elderly. Hip arthroplasty is the most frequently performed procedure for patients with an intracapsular hip fracture. The majority of national guidelines recommend total hip arthroplasty (THA) for more active patients. Literature indicates significant stability advantages for dual mobility (DM) acetabular components in non-emergent scenarios. Evidence supporting the use of DM in hip fracture patients is limited. Aim We set out to ascertain if DM implants offer stability and/or functional advantages over standard THA in patients with hip fracture. Methods We utilised our local National Hip Fracture Database to identify all patients undergoing either a standard or DM THA for hip fracture (n=477) We matched cohorts based on age, AMTS, mobility status pre-operatively, gender, ASA and source of admission. Our primary outcome of interest was functional status using the oxford hip score (OHS). Secondary outcome measures included dislocation, fracture and deep infection requiring further surgery. Results 62 patient pairs were available for this study. Mean OHS for DM THA was 41.5 and for standard THA this was 42.7 (p=0.58). There were 4 dislocations in the standard THA group and 0 with DM THA. No difference was seen with infection or peri-prosthetic fracture. Conclusion This study demonstrates functional equivalence between DM and standard THA. In addition it shows a trend towards less dislocation with DM THA. Cost savings from less instability may outweigh initial prosthesis costs. This study suggests a suitably powered RCT using instability as the primary outcome measure is indicated.
- Published
- 2021
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