Achudan Shaam, Fang Christopher, Xiang Ng Wei, Decruz Joshua, Kunnasegaran Remesh
Department of Orthopedics, Tan Tock Seng Hospital, Singapore, Singapore.
Department of Orthopedics, Khoo Teck Puat Hospital, Singapore, Singapore.
Indian J Orthop. 2022 Nov 27;57(1):62-70. doi: 10.1007/s43465-022-00759-5. eCollection 2023 Jan.
Studies comparing the use of total hip arthroplasty (THA) with conventional implants and hemiarthroplasty for displaced femoral neck fractures (DFNF) have reported better patient satisfaction scores and outcomes in the former, but also significant dislocation rates (6.9-13%).The total hip arthroplasty with dual mobility cup (THA-DMC) design is mechanically proven to increase the hip range of motion and jump distance to dislocation relative to conventional implants. Despite its potential benefit, clinical studies analyzing the use of THA-DMC in the treatment of DFNF in comparison to conventional THA within the Asian population are still limited. Our study aims to compare the rate of complications and functional outcomes between the 2 implants in the treatment of DFNF.
This was a retrospective cohort study conducted in a single tertiary care institution. From January 2015 to May 2020, data from 129 consecutive patients who satisfied the inclusion criteria and underwent either a THA or THA-DMC for DFNF were collected and divided into 2 groups. All patients received a standardized post-operative treatment and follow-up regime. Both groups of patients were assessed for post-operative complications such as dislocation, peri-prosthetic fractures, surgical site infections, medical complications. Their functional outcomes as well as patient-reported outcome scores were also assessed via the SF-36 score and Oxford hip score questionnaires at 6 months and 1 year.
A total of 42 patients with dual mobility implants and 87 patients with conventional implants were recruited. There was no dislocation in the THA-DMC group while there were 4 cases (4/87, 4.6%) of dislocation in the THA group. Regarding post-operative function, both groups had comparable functional outcomes. There were no statistically significant differences between the patient-reported outcome scores (Oxford hip score and SF-36) at 6 months and 1 year.
We report promising short-term outcomes utilizing dual mobility implants in total hip arthroplasty for the treatment of DFNFs.
比较全髋关节置换术（THA）使用传统植入物与半髋关节置换术治疗移位型股骨颈骨折（DFNF）的研究报告称，前者患者满意度评分和治疗效果更好，但脱位率也较高（6.9%-13%）。相对于传统植入物，双动杯全髋关节置换术（THA-DMC）设计在力学上被证明可增加髋关节活动范围和脱位跳跃距离。尽管有潜在益处，但在亚洲人群中，分析THA-DMC与传统THA治疗DFNF的临床研究仍然有限。我们的研究旨在比较这两种植入物治疗DFNF的并发症发生率和功能结果。
这是一项在单一三级医疗机构进行的回顾性队列研究。2015年1月至2020年5月，收集了129例符合纳入标准并因DFNF接受THA或THA-DMC治疗的连续患者的数据，并分为两组。所有患者均接受标准化的术后治疗和随访方案。评估两组患者的术后并发症，如脱位、假体周围骨折、手术部位感染、医疗并发症。还通过SF-36评分和牛津髋关节评分问卷在6个月和1年时评估他们的功能结果以及患者报告的结果评分。
共招募了42例使用双动植入物的患者和87例使用传统植入物的患者。THA-DMC组未发生脱位，而THA组有4例（4/87，4.6%）脱位。关于术后功能，两组的功能结果相当。在6个月和1年时，患者报告的结果评分（牛津髋关节评分和SF-36）之间没有统计学显著差异。
我们报告了在全髋关节置换术中使用双动植入物治疗DFNF的有前景的短期结果。
