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Dislocation of hemiarthroplasty after hip fracture is common and the risk is increased with posterior approach : result from a national cohort of 25,678 individuals in the Swedish Hip Arthroplasty Register

Jobory, Ammar LU ; Kärrholm, Johan ; Hansson, Susanne LU orcid ; Åkesson, Kristina LU and Rogmark, Cecilia LU (2021) In Acta Orthopaedica 92(4). p.413-418
Abstract

Background and purpose — Reported revision rates due to dislocation after hemiarthroplasty span a wide range. Dislocations treated with closed reduction are rarely reported despite the fact that they can be expected to constitute most of the dislocations that occur. We aimed to describe the total dislocation rate on the national level, and to identify risk factors for dislocation. Patients and methods — We co-processed a national cohort of 25,678 patients in the Swedish Hip Arthroplasty Register, with the National Patient Register (NPR) and Statistics Sweden. Dislocation was defined as the occurrence of any ICD-10 or procedural code related to hip dislocation recorded in the NPR, with a minimum of 1-year-follow-up. In theory, all early... (More)

Background and purpose — Reported revision rates due to dislocation after hemiarthroplasty span a wide range. Dislocations treated with closed reduction are rarely reported despite the fact that they can be expected to constitute most of the dislocations that occur. We aimed to describe the total dislocation rate on the national level, and to identify risk factors for dislocation. Patients and methods — We co-processed a national cohort of 25,678 patients in the Swedish Hip Arthroplasty Register, with the National Patient Register (NPR) and Statistics Sweden. Dislocation was defined as the occurrence of any ICD-10 or procedural code related to hip dislocation recorded in the NPR, with a minimum of 1-year-follow-up. In theory, all early dislocations should thereby be traced, including those treated with closed reduction only. Results — 366/13,769 (2.7%) patients operated on with direct lateral approach dislocated, compared with 850/11,834 (7.2%) of those with posterior approach. Posterior approach was the strongest risk factor for dislocation (OR = 2.7; 95% CI 2.3–3.1), followed by dementia (OR = 1.3; CI 1.1–1.5). The older the patients, the lower the risk of dislocation (OR = 0.98 per year of age; CI 0.98–1.0). Neither bipolar design nor cementless stems influenced the risk. Interpretation — The choice of posterior approach and dementia was associated with an increased dislocation risk. When hips treated with closed reduction were identified, the frequency of dislocation with use of direct lateral and posterior approach more than doubled and tripled, respectively, compared with when only revisions due to dislocation are measured.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
92
issue
4
pages
413 - 418
publisher
Taylor & Francis
external identifiers
  • scopus:85103678112
  • pmid:33821752
ISSN
1745-3674
DOI
10.1080/17453674.2021.1906517
language
English
LU publication?
yes
id
ceb28b75-8d3d-49e0-bde0-4f16534ecbd1
date added to LUP
2021-04-13 13:47:06
date last changed
2024-04-20 04:42:38
@article{ceb28b75-8d3d-49e0-bde0-4f16534ecbd1,
  abstract     = {{<p>Background and purpose — Reported revision rates due to dislocation after hemiarthroplasty span a wide range. Dislocations treated with closed reduction are rarely reported despite the fact that they can be expected to constitute most of the dislocations that occur. We aimed to describe the total dislocation rate on the national level, and to identify risk factors for dislocation. Patients and methods — We co-processed a national cohort of 25,678 patients in the Swedish Hip Arthroplasty Register, with the National Patient Register (NPR) and Statistics Sweden. Dislocation was defined as the occurrence of any ICD-10 or procedural code related to hip dislocation recorded in the NPR, with a minimum of 1-year-follow-up. In theory, all early dislocations should thereby be traced, including those treated with closed reduction only. Results — 366/13,769 (2.7%) patients operated on with direct lateral approach dislocated, compared with 850/11,834 (7.2%) of those with posterior approach. Posterior approach was the strongest risk factor for dislocation (OR = 2.7; 95% CI 2.3–3.1), followed by dementia (OR = 1.3; CI 1.1–1.5). The older the patients, the lower the risk of dislocation (OR = 0.98 per year of age; CI 0.98–1.0). Neither bipolar design nor cementless stems influenced the risk. Interpretation — The choice of posterior approach and dementia was associated with an increased dislocation risk. When hips treated with closed reduction were identified, the frequency of dislocation with use of direct lateral and posterior approach more than doubled and tripled, respectively, compared with when only revisions due to dislocation are measured.</p>}},
  author       = {{Jobory, Ammar and Kärrholm, Johan and Hansson, Susanne and Åkesson, Kristina and Rogmark, Cecilia}},
  issn         = {{1745-3674}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{413--418}},
  publisher    = {{Taylor & Francis}},
  series       = {{Acta Orthopaedica}},
  title        = {{Dislocation of hemiarthroplasty after hip fracture is common and the risk is increased with posterior approach : result from a national cohort of 25,678 individuals in the Swedish Hip Arthroplasty Register}},
  url          = {{http://dx.doi.org/10.1080/17453674.2021.1906517}},
  doi          = {{10.1080/17453674.2021.1906517}},
  volume       = {{92}},
  year         = {{2021}},
}