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

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 he...

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Autores principales: Iorio, Raffaele, Iannotti, Ferdinando, Mazza, Daniele, Speranza, Attilio, Massafra, Carlo, Guzzini, Matteo, D’Arrigo, Carmelo, Ferretti, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824440/
https://www.ncbi.nlm.nih.gov/pubmed/31674902
http://dx.doi.org/10.1051/sicotj/2019035
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author Iorio, Raffaele
Iannotti, Ferdinando
Mazza, Daniele
Speranza, Attilio
Massafra, Carlo
Guzzini, Matteo
D’Arrigo, Carmelo
Ferretti, Andrea
author_facet Iorio, Raffaele
Iannotti, Ferdinando
Mazza, Daniele
Speranza, Attilio
Massafra, Carlo
Guzzini, Matteo
D’Arrigo, Carmelo
Ferretti, Andrea
author_sort Iorio, Raffaele
collection PubMed
description 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.
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spelling pubmed-68244402019-11-13 Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial Iorio, Raffaele Iannotti, Ferdinando Mazza, Daniele Speranza, Attilio Massafra, Carlo Guzzini, Matteo D’Arrigo, Carmelo Ferretti, Andrea SICOT J Original Article 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. EDP Sciences 2019-11-01 /pmc/articles/PMC6824440/ /pubmed/31674902 http://dx.doi.org/10.1051/sicotj/2019035 Text en © The Authors, published by EDP Sciences, 2019 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Iorio, Raffaele
Iannotti, Ferdinando
Mazza, Daniele
Speranza, Attilio
Massafra, Carlo
Guzzini, Matteo
D’Arrigo, Carmelo
Ferretti, Andrea
Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial
title Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial
title_full Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial
title_fullStr Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial
title_full_unstemmed Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial
title_short Is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? A randomized controlled trial
title_sort is dual cup mobility better than hemiarthroplasty in patients with dementia and femoral neck fracture? a randomized controlled trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824440/
https://www.ncbi.nlm.nih.gov/pubmed/31674902
http://dx.doi.org/10.1051/sicotj/2019035
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