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Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial
- Source :
- SICOT-J, Vol 5, p 38 (2019), SICOT-J
- Publication Year :
- 2019
- Publisher :
- EDP Sciences, 2019.
-
Abstract
- Purpose: Treatment of patients with dementia and hip fracture is challenging. Total hip arthroplasty (THA) with dual mobility cup (DMC) has been designed to reduce the rate of dislocation by increasing the stability of the implant. This study aimed to compare the dislocation rates of DMC THA with hemiarthroplasty (HA) in elderly patients with displaced femoral neck fracture (FNF) and a diagnosis of dementia. Methods: All patients with a displaced FNF and dementia diagnosis were prospectively randomized to hemiarthroplasty or THA with DMC treatment during a 2-year period. Finally, the outcomes of 30 patients in the HA group were compared with those of 30 patients in the DMC THA group. Dislocation rate at a minimum follow-up of 1 year was evaluated as the primary outcome. Reoperation rate, time to surgery, surgical time, length of hospital stay, and 30-day and 1-year mortality were also evaluated. Results: There was a significant difference regarding rates of dislocation in favor of THA with DMC and with regard to length of surgery (p = 0.04) in favor of bipolar HA. Dislocation occurred in five patients (16.6%) treated with bipolar HA and no one (0%) in patients treated with THA with DMC (p = 0.019). There was no difference with regard to the 30-day mortality, 1-year mortality, reoperations, and length of hospital stay between the two groups of patients. Discussion: THA with DMC seems to be a safe and reliable choice to reduce the rate of dislocation at 1 year in patients with dementia and FNF without a higher risk of mortality.
- Subjects :
- medicine.medical_specialty
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
lcsh:Orthopedic surgery
law
medicine
Risk of mortality
Dementia
Orthopedics and Sports Medicine
In patient
dual mobility cup
030212 general & internal medicine
hemiarthroplasty
Femoral neck
030222 orthopedics
Hip fracture
Hip
femoral neck fracture
dislocation
business.industry
medicine.disease
Dual mobility
Surgery
lcsh:RD701-811
medicine.anatomical_structure
Original Article
Implant
business
dementia
Subjects
Details
- Language :
- English
- ISSN :
- 24268887
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- SICOT-J
- Accession number :
- edsair.doi.dedup.....1ceb95c1592a2036e55fb2b33898bbae