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Choice of approach, but not femoral head size, affects revision rate due to dislocations in THA after femoral neck fracture: results from the Lithuanian Arthroplasty Register

Cebatorius, Algimantas; Robertsson, Otto LU ; Stucinskas, Justinas; Smailys, Alfredas; Leonas, Linas and Tarasevicius, Sarunas (2015) In International Orthopaedics 39(6). p.1073-1076
Abstract
Purpose Hip dislocation after arthroplasty for femoral neck fractures (FNF) remains a serious complication. The aim of our study was to investigate FNF patients treated with THA, with a special focus of comparing the effect of surgical approach and femoral head size on the risk of revision for dislocation. Methods Data were derived from the Lithuanian Arthroplasty Register, and we calculated the cumulative revision rates after surgery. For survival analysis, we used revision due to dislocation as an end-point. Cox proportional hazards models were used to analyse the influence of various covariates (age, gender, femoral head size, surgical approach). Results A total of 8,813 primary THAs were registered from 1 January 2011 to 31 December... (More)
Purpose Hip dislocation after arthroplasty for femoral neck fractures (FNF) remains a serious complication. The aim of our study was to investigate FNF patients treated with THA, with a special focus of comparing the effect of surgical approach and femoral head size on the risk of revision for dislocation. Methods Data were derived from the Lithuanian Arthroplasty Register, and we calculated the cumulative revision rates after surgery. For survival analysis, we used revision due to dislocation as an end-point. Cox proportional hazards models were used to analyse the influence of various covariates (age, gender, femoral head size, surgical approach). Results A total of 8,813 primary THAs were registered from 1 January 2011 to 31 December 2013, of which 1,412 were due to FNF: 899 involved 28-mm femoral heads and the remaining 513 received 32-mm heads. The posterior approach was used in 1,156 cases and the anterolateral approach in 256.. At the end of the follow-up period, 74 hips had been revised for recurrent dislocation. Cox regression adjusting for age, gender and head size showed that the posterior approach had 2.3-times [95% confidence interval (CI): 1.0-5.0, p = 0.04] greater risk of revision for dislocation Conclusions We conclude that in order to reduce the early dislocation rate in FNF patients treated with THA, it is more effective to use the anterolateral approach than it is to select a femoral head size of 32 mm instead of 28 mm. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Total hip arthroplasty, Dislocation, Revision, Register
in
International Orthopaedics
volume
39
issue
6
pages
1073 - 1076
publisher
Springer
external identifiers
  • wos:000355755600006
  • scopus:84930485890
ISSN
1432-5195
DOI
10.1007/s00264-014-2618-1
language
English
LU publication?
yes
id
01fcd9e0-b76b-4308-81d7-7f942764b947 (old id 7612562)
date added to LUP
2015-08-03 10:11:56
date last changed
2017-11-19 03:54:41
@article{01fcd9e0-b76b-4308-81d7-7f942764b947,
  abstract     = {Purpose Hip dislocation after arthroplasty for femoral neck fractures (FNF) remains a serious complication. The aim of our study was to investigate FNF patients treated with THA, with a special focus of comparing the effect of surgical approach and femoral head size on the risk of revision for dislocation. Methods Data were derived from the Lithuanian Arthroplasty Register, and we calculated the cumulative revision rates after surgery. For survival analysis, we used revision due to dislocation as an end-point. Cox proportional hazards models were used to analyse the influence of various covariates (age, gender, femoral head size, surgical approach). Results A total of 8,813 primary THAs were registered from 1 January 2011 to 31 December 2013, of which 1,412 were due to FNF: 899 involved 28-mm femoral heads and the remaining 513 received 32-mm heads. The posterior approach was used in 1,156 cases and the anterolateral approach in 256.. At the end of the follow-up period, 74 hips had been revised for recurrent dislocation. Cox regression adjusting for age, gender and head size showed that the posterior approach had 2.3-times [95% confidence interval (CI): 1.0-5.0, p = 0.04] greater risk of revision for dislocation Conclusions We conclude that in order to reduce the early dislocation rate in FNF patients treated with THA, it is more effective to use the anterolateral approach than it is to select a femoral head size of 32 mm instead of 28 mm.},
  author       = {Cebatorius, Algimantas and Robertsson, Otto and Stucinskas, Justinas and Smailys, Alfredas and Leonas, Linas and Tarasevicius, Sarunas},
  issn         = {1432-5195},
  keyword      = {Total hip arthroplasty,Dislocation,Revision,Register},
  language     = {eng},
  number       = {6},
  pages        = {1073--1076},
  publisher    = {Springer},
  series       = {International Orthopaedics},
  title        = {Choice of approach, but not femoral head size, affects revision rate due to dislocations in THA after femoral neck fracture: results from the Lithuanian Arthroplasty Register},
  url          = {http://dx.doi.org/10.1007/s00264-014-2618-1},
  volume       = {39},
  year         = {2015},
}