Comparison of outcomes of dual-mobility cemented total hip arthroplasty versus bipolar cemented hemiarthroplasty in patients with femoral neck fractures

Authors

  • Shady G. Elsadany Department of Orthopaedic Surgery, Faculty of Medicine, Port Said University, Port Fuad, Egypt
  • Khaled S. Salama Department of Orthopaedic Surgery, Faculty of Medicine, Port Said University, Port Fuad, Egypt
  • Mohamed E. Elgreatly Department of Orthopaedic Surgery, Faculty of Medicine, Port Said University, Port Fuad, Egypt
  • Mohamed Abdelaziz Department of Orthopaedic Surgery, Faculty of Medicine, Port Said University, Port Fuad, Egypt

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20243012

Keywords:

Elderly, Femoral fractures, Hemiarthroplasty, Hip arthroplasty, Tripolar, Bipolar, Dual mobility

Abstract

Background: Elderly people with femoral neck fractures are more likely to experience complications after hip replacement. Compared with total tripolar hip arthroplasty (THA), bipolar hemiarthroplasty (HA), more effective alternative treatments that improve overall safety. We aimed to review the benefits of dual mobility tripolar arthroplasty and compare it to bipolar hemiarthroplasty in treatment of the femoral neck in the elderly.

Methods: This study was conducted as a comparative randomized controlled prospective study. Patients were divided randomly to two equal groups 19 patients each one group underwent cemented bipolar hip hemi arthroplasty and the other group underwent cemented tripolar total hip arthroplasty, surgical approach for the two study groups was modified lateral Hardinge approach. The patients were followed up after one month, three months 6 months and one year. The follow up period was one year, and modified Harris hip score was reported, and radiograph scan of fracture site was done before and after surgery. Complications were reported whether intraoperative or in the follow up period.

Results: The result of the study showed that the operative time was much longer in tripolar group as compared to bipolar group, there was more blood loss in tripolar group more than bipolar group. The functional outcome assessed using Harris hip score showed better outcome in tripolar group as compared to bipolar group. As regard complication, there was one case of periprosthetic fracture intraoperative in bipolar group and one case of cement extrusion in tripolar group. There was no dislocation in both groups.

Conclusions: Tripolar total hip arthroplasty had better functional outcome than bipolar hip hemiarthroplasty and we recommend more studies for a longer period of follow up to assess rate of complications and functional outcome on the long run.

References

Sayana MK, Lakshmanan P, Peehal JP, Wynn-Jones C, Maffulli N. Total hip replacement for acute femoral neck fracture: a survey of National Joint Registries. Acta Orthop Belg. 2008;74(1):54-8.

Guyen O. Hemiarthroplasty or total hip arthroplasty in recent femoral neck fractures? Orthop Traumatol Surg Res. 2019;105(1S):S95-101.

Migliorini F, Trivellas A, Driessen A, Quack V, El Mansy Y, Schenker H, et al. Hemiarthroplasty versus total arthroplasty for displaced femoral neck fractures in the elderly: meta-analysis of randomized clinical trials. Arch Orthop Trauma Surg. 2020;140(11):1695.

Darrith B, Courtney PM, Della Valle CJ. Outcomes of dual mobility components in total hip arthroplasty: a systematic review of the literature. Bone Joint J. 2018;100-B(1):11-9.

Lewis DP, Waever D, Thorninger R, Donnelly WJ. Hemiarthroplasty vs total hip arthroplasty for the management of displaced neck of femur fractures: a systematic review and meta-analysis. J Arthroplast. 2019;34(8):1837-43.

Shabat S, Mann G, Nyska M, Maffulli N. Scoring systems to evaluate elderly patients with hip fractures. Disabil Rehabil. 2005;27(18-19):1041-4.

Douglas S, Bunyan A, Chiu KH, Twaddle B, Maffulli N. Seasonal variation of hip fracture at three latitudes. Injury. 2000;31(1):11-9.

Rose S, Maffulli N. Hip fractures. An epidemiological review. Bull Hosp Jt Dis. 1999;58(4):197-201.

Nonne D, Sanna F, Bardelli A, Milano P, Rivera F. Use of a dual mobility cup to prevent hip early arthroplasty dislocation in patients at high falls risk. Injury. 2019;50(4):S26-9.

Ukaj S, Zhuri O, Ukaj F, Podvorica V, Grezda K, Caton J, et al. Dual mobility acetabular cup versus hemiarthroplasty in treatment of displaced femoral neck fractures in elderly patients: comparative study and results at minimum 3-year follow-up. Geriatr Orthop Surg Rehabil. 2019;10:2151459319848610.

Iorio R, Iannotti F, Mazza D, Speranza A, Massafra C, Guzzini M, et al. Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial. SICOT J. 2019;5:38.

Abdelkhalek M, Abdelwahab M, Ali AM. Bipolar versus fixed-head hip arthroplasty for femoral neck fractures in elderly patients. Strategies Trauma Limb Reconstr. 2011;6(1):1-6.

von Roth P, Abdel MP, Harmsen WS, Berry DJ. Cemented Bipolar Hemiarthroplasty Provides Definitive Treatment for Femoral Neck Fractures at 20 Years and Beyond. Clin Orthop Relat Res. 2015;473(11):3595-9.

Lim LS, Hoeksema LJ, Sherin K. ACPM Prevention Practice Committee. Screening for osteoporosis in the adult U.S. population: ACPM position statement on preventive practice. Am J Prev Med. 2009;36:366-75.

Nowak LL, Schemitsch EH. Duration of surgery affects the risk of complications following total hip arthroplasty. Bone Joint J. 2019;101-B(6):51-6.

Ossendorf C, Scheyerer MJ, Wanner GA, Simmen HP, Werner CM. Treatment of femoral neck fractures in elderly patients over 60 years of age - which is the ideal modality of primary joint replacement? Patient Saf Surg. 2010,4:16.

Dawson D, Milligan D, Callachand F, Cusick L. Hip hemi-arthroplasty vs total hip replacement for displaced intra-capsular hip fractures: retrospective age and sex matched cohort study. Ulster Med J. 2018;87:17-21.

Wang F, Zhang H, Zhang Z, Ma C, Feng X. Comparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis. BMC Musculoskelet Disord. 2015;16:229.

Abdelkhalek M, Abdelwahab M, Ali AM. Bipolar versus fixed-head hip arthroplasty for femoral neck fractures in elderly patients. Strategies Trauma Limb Reconstr. 2011;6(1):1-6.

Mazen S, Julien G, Riad F. Retrospective evaluation of bipolar hip arthroplasty in fractures of the proximal femur. N Am J Med Sci. 2010;2(9):409-15.

Hinchey JJ, Day PL. Primary prosthetic replacement in fresh femoral neck fractures. J Bone Joint Surg Am. 1960;42:633-40.

Burgers PT, Van Geene AR, Van den Bekerom MP, Van Lieshout EM, Blom B, Aleem IS, et al. Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis and systematic review of randomized trials. Int Orthop. 2012;36(8):1549-60.

Haidukewych GJ, Israel TA, Berry DJ. Long-term survivorship of cemented bipolar hemiarthroplasty for fracture of the femoral neck. Clin Orthop Relat Res. 2002;(403):118-26.

van den Bekerom MP, Hilverdink EF, Sierevelt IN, Reuling EM, Schnater JM, Bonke H, et al. A comparison of hemiarthroplasty with total hip replacement for displaced intracapsular fracture of the femoral neck: a randomised controlled multicentre trial in patients aged 70 years and over. J Bone Joint Surg Br. 2010;92(10):1422-8.

Avery PP, Baker RP, Walton MJ, Rooker JC, Squires B, Gargan MF, et al. Total hip replacement and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck: a seven- to ten-year follow-up report of a prospective randomised controlled trial. J Bone Joint Surg Br. 2011;93(8):1045-8.

Tol MC, van den Bekerom MP, Sierevelt IN, Hilverdink EF, Raaymakers EL, Goslings JC. Hemiarthroplasty or total hip arthroplasty for the treatment of a displaced intracapsular fracture in active elderly patients: 12-year follow-up of randomised trial. Bone Joint J. 2017;99-B(2):250-4.

Blomfeldt R, Törnkvist H, Eriksson K, Söderqvist A, Ponzer S, Tidermark J. A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. J Bone Joint Surg Br. 2007;89(2):160-5.

Hedbeck CJ, Enocson A, Lapidus G, Blomfeldt R, Törnkvist H, Ponzer S, et al. Comparison of bipolar hemiarthroplasty with total hip arthroplasty for displaced femoral neck fractures: a concise four-year follow-up of a randomized trial. J Bone Joint Surg Am. 2011;93(5):445-50.

Mouzopoulos G, Stamatakos M, Arabatzi H, Vasiliadis G, Batanis G, Tsembeli A, et al. The four-year functional result after a displaced subcapital hip fracture treated with three different surgical options. Int Orthop. 2008;32(3):367-73.

Parker MJ, Gurusamy KS, Azegami S. Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev. 2010;6:CD001706.

Kannan A, Kancherla R, McMahon S, Hawdon G, Soral A, Malhotra R. Arthroplasty options in femoral-neck fracture: answers from the national registries. Int Orthop. 2012;36(1):1-8.

Lin CC, Huang SC, Ou YK, Liu YC, Tsai CM, Chan HH, et al. Survival of patients aged over 80 years after Austin-Moore hemiarthroplasty and bipolar hemiarthroplasty for femoral neck fractures. Asian J Surg. 2012;35(2):62-6.

Hopley C, Stengel D, Ekkernkamp A, Wich M. Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ. 2010;340:c2332.

Ko LM, Hozack WJ. The dual mobility cup: what problems does it solve? Bone Joint J. 2016;98-B(1):60-3.

Buecking B, Boese CK, Bergmeister VA, Frink M, Ruchholtz S, Lechler P. Functional implications of femoral offset following hemiarthroplasty for displaced femoral neck fracture. Int Orthop. 2016;40:1515-21.

Haidukewych GJ, Israel TA, Berry DJ. Long-term survivorship of cemented bipolar hemiarthroplasty for fracture of the femoral neck. Clin Orthop Relat Res. 2002;403:118-260.

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Published

2024-10-15

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Original Research Articles