Should we employ preoperative templating in hip hemiarthroplasty after femoral neck fracture? A nested case-control study.

Autor:	Pujol O; Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain., Carrasco MG; Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain., Vicente M; Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain.; Septic and Reconstructive Surgery Unit, Orthopaedic Surgery Department, Vall d'Hebron University, Barcelona, Spain., Mimendia I; Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain.; Hip Surgery Unit, Orthopaedic Surgery Department, Vall d'Hebron University, Barcelona, Spain., García Y; Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain.; Vall d'Hebron Institute of Research (VHIR), Vall d'Hebron University, Barcelona, Spain., Selga J; Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain.; Trauma Surgery Unit, Orthopaedic Surgery Department, Vall d'Hebron University, Barcelona, Spain., Barro V; Orthopaedic Surgery Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain.; Hip Surgery Unit, Orthopaedic Surgery Department, Vall d'Hebron University, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Hip international : the journal of clinical and experimental research on hip pathology and therapy [Hip Int] 2022 Jul; Vol. 32 (4), pp. 537-542. Date of Electronic Publication: 2020 Oct 19.
DOI:	10.1177/1120700020964776
Abstrakt:	Introduction: Dislocation following hip hemiarthroplasty is a serious complication. It remains unclear if acetabular morphology is associated with a higher risk of dislocation. The aim of our study was to investigate whether there are differences in hip morphology radiological parameters between patients who have suffered a dislocation episode, and those who have not suffered a dislocation. Material and Methods: Between January 2015 and December 2018, a nested case-control study was performed. From 707 patients who underwent hip hemiarthroplasty because of femoral neck fracture, 50 patients (50 hips) suffered an episode of dislocation. They were randomly matched with 94 patients (100 hips) without dislocation (ratio 1:2). Clinical data regarding demographics, medical comorbidities and surgical and radiological parameters were studied. Results: Statistically significantly smaller lateral centre-edge angle (LCEA) and femoral offset (FO) and greater Tönnis angle were found in the dislocation group. No differences in acetabular angle were seen. Neurological impairment prevalence was statistically significantly higher in patients who suffered a dislocation (60% vs. 44%, p  = 0.011). Conclusions: The current study suggests that a smaller LCEA and FO, a greater TA, and neurological impairment could be related to a higher risk of hip hemiarthroplasty dislocation after femoral neck fracture in the elderly. We consider that preoperative templating could be helpful in identifying abnormal parameters and carefully planning surgery could lead to changes in treatment strategy, such as choosing a dual-mobility total hip arthroplasty.
Databáze:	MEDLINE
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