Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019:5:38.
doi: 10.1051/sicotj/2019035. Epub 2019 Nov 1.

Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial

Raffaele Iorio  1 , Ferdinando Iannotti  1 , Daniele Mazza  1 , Attilio Speranza  1 , Carlo Massafra  1 , Matteo Guzzini  1 , Carmelo D'Arrigo  1 , Andrea Ferretti  1
Affiliations

Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial

Raffaele Iorio et al. SICOT J. 2019.

Abstract

Purpose: Treatment of patients with dementia and hip fracture is challenging. Total hip arthroplasty (THA) with dual mobility cup (DMC) has been designed to reduce the rate of dislocation by increasing the stability of the implant. This study aimed to compare the dislocation rates of DMC THA with hemiarthroplasty (HA) in elderly patients with displaced femoral neck fracture (FNF) and a diagnosis of dementia.

Methods: All patients with a displaced FNF and dementia diagnosis were prospectively randomized to hemiarthroplasty or THA with DMC treatment during a 2-year period. Finally, the outcomes of 30 patients in the HA group were compared with those of 30 patients in the DMC THA group. Dislocation rate at a minimum follow-up of 1 year was evaluated as the primary outcome. Reoperation rate, time to surgery, surgical time, length of hospital stay, and 30-day and 1-year mortality were also evaluated.

Results: There was a significant difference regarding rates of dislocation in favor of THA with DMC and with regard to length of surgery (p = 0.04) in favor of bipolar HA. Dislocation occurred in five patients (16.6%) treated with bipolar HA and no one (0%) in patients treated with THA with DMC (p = 0.019). There was no difference with regard to the 30-day mortality, 1-year mortality, reoperations, and length of hospital stay between the two groups of patients.

Discussion: THA with DMC seems to be a safe and reliable choice to reduce the rate of dislocation at 1 year in patients with dementia and FNF without a higher risk of mortality.

Keywords: Dementia; Dislocation; Dual mobility cup; Femoral neck fracture; Hemiarthroplasty.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Participant flowchart of the enrollment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sterling RS (2011) Gender and race/ethnicity differences in hip fracture incidence, morbidity, mortality, and function. Clin Orthop Relat Res 469(7), 1913–1918. - PMC - PubMed
    1. Kannus P, Parkkari J, Sievanen H, et al. (1996) Epidemiology of hip fractures. Bone 18(1), S57–S63. - PubMed
    1. Khan MA, Hossain FS, Ahmed I, Muthukumar N, Mohsen A (2013) Predictors of early mortality after hip fracture surgery. Int Orthop 37(11), 2119–2124. - PMC - PubMed
    1. Tsuda Y, Yasunaga H, Horiguchi H, Ogawa S, Kawano H, Tanaka S (2015) Association between dementia and postoperative complications after hip fracture surgery in the elderly: Analysis of 87,654 patients using a national administrative database. Arch Orthop Trauma Surg 135(11), 1511–1517. - PubMed
    1. Wang HK, Hung CM, Lin SH, Tai YC, Lu K, Liliang PC, Lin CW, Lee YC, Fang PH, Chang LC, Li YC (2014) Increased risk of hip fractures in patients with dementia: A nationwide population-based study. BMC Neurol 12(14), 175. - PMC - PubMed

LinkOut - more resources