Is dual mobility cup total hip replacement associated with increased incidence of heterotopic ossification compared to conventional total hip replacements in fracture neck of femur patients?

Autor: Rashed RA; Senior Clinical Fellow of Orthopedics and Trauamtology, Oxford University Hospitals NHS Trust, UK. Electronic address: ramyrashed@doctors.org.uk., Abdalaziz A; Specialty Registrar Trauma and Orthopedic Surgery, East Lancashire Hospitals NHS Trust, UK., Veivenn VY; Foundation Year Doctor, East Lancashire Hospitals NHS Trust, UK., Tetali SR; Clinical Research Fellow, Trauma and Orthopedics, Lancashire Teaching Hospitals NHS Trust, UK., Choudry QA; Consultant of Orthopedics and Traumatology, East Lancashire Hospitals NHS Trust, UK., Sloan AG; Consultant of Orthopedics and Traumatology, Lancashire Teaching Hospitals NHS Trust, UK., Helm A; Oxford University Hospitals NHS Trust, UK; Royal Blackburn Hospital, Haslingden road, Blackburn, BB2 3 HH, UK; Royal Preston Hospital, Sharoe Green Ln, Fulwood, Preston, PR2 9HT, UK.
Jazyk: angličtina
Zdroj: Injury [Injury] 2020 Nov; Vol. 51 (11), pp. 2676-2681. Date of Electronic Publication: 2020 Jul 21.
DOI: 10.1016/j.injury.2020.07.045
Abstrakt: Introduction: The incidence of heterotopic ossification after total hip replacement is variable in the literature. If symptomatic, it may cause pain and reduced range of motion. Dual mobility total hip replacements have been considered a valuable option for the treatment of femoral neck fractures in the active patients, achieving good range of motion with reduced risk of dislocation. The occurrence of HO may have detrimental effect on this type of articulation and may accelerate polyethylene wear and predispose to intra-prosthetic dislocation. We compared the incidence of HO in DMC versus conventional THR in femoral neck fracture patients across 3 large trauma institutes PATIENTS AND METHODS: This is a retrospective cohort study which included 334 patients, 223 received DMC replacements, 111 received conventional total hip replacement (THR). Mean age for the DMC group was 72.3 ± 9.9 years and was 72.1 ± 6.8 years for the THR group. Patients were stratified according to specific inclusion and exclusion criteria, and the 1-year follow up X rays were evaluated for the presence of heterotopic ossification by 3 assessors.
Results: The incidence of HO in the DMC group was 27.1% compared to 12.2% in the THR group (χ 2 p value = 0.0001, Relative Risk = 2.22, 95% CI 1.22-4.03, p value = 0.0091). There was no significant effect of gender or age on the incidence of HO in both groups CONCLUSIONS: Patients receiving DMC hip replacements are more likely to develop HO as compared to patients receiving conventional THR for femoral neck fractures. Further prospective studies are required to confirm our findings and to assess the indication of HO prophylaxis in patients receiving DMC hip replacements, and the long-term outcomes in these patients.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2020. Published by Elsevier Ltd.)
Databáze: MEDLINE
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