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A primary arthroplasty constitutes a standard procedure in the treatment of patients with displaced fractures of the femoral neck. Although dislocation of the prosthesis remains a significant clinical problem, there are no previous reports on its influence on health-related quality of life (HRQoL). We analysed how a dislocation of the hip arthroplasty influenced the patients’ HRQoL.
In total 319 consecutive patients with a displaced fracture of the femoral neck treated with a primary arthroplasty were included in a prospective cohort study. We used a mixed-effects model regression analysis to evaluate factors of importance for HRQoL (EQ-5Dindex score) during the first 12 months following surgery.
A dislocation of the arthroplasty occurred in 21 of the 319 patients (7%), 8 of whom had a single dislocation and 13 recurrent dislocations. At 4 months, the EQ-5Dindex score displayed a significantly worse outcome for patients with recurrent dislocations compared to patients with no dislocation (P = 0.001), and a trend towards a worse outcome for patients with a single dislocation (P = 0.08). At 12 months, the mean EQ-5Dindex score of patients with recurrent dislocations was still substantially lower (P = 0.001), while the EQ-5Dindex score for patients with a single dislocation had returned to a level similar to that of patients with no dislocation. Our analysis of the EQ-5D dimensions indicates that the difference was mainly due to perceived difficulties in self-care and usual activities and increased problems with anxiety/depression.
A recurrent dislocation of the hip arthroplasty in the treatment of patients with femoral neck fractures seems to result in a persisting deterioration in the HRQoL, while patients with a single dislocation seem to experience only a temporary deterioration.
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Tidermark, J., Ponzer, S., Svensson, O., Söderqvist, A., & Törnkvist, H. (2003). Internal fixation compared with total hip replacement for displaced femoral neck fractures in the elderly. A randomised, controlled trial. Journal of Bone and Joint Surgery. British Volume, 85(3), 380–388. doi: 10.1302/0301-620X.85B3.13609. PubMedCrossRef
Keating, J. F., Grant, A., Masson, M., Scott, N. W., & Forbes, J. F. (2006). Randomized comparison of reduction and fixation, bipolar hemiarthroplasty, and total hip arthroplasty. Treatment of displaced intracapsular hip fractures in healthy older patients. Journal of Bone and Joint Surgery. American Volume, 88(2), 249–260. doi: 10.2106/JBJS.E.00215. CrossRef
Blomfeldt, R., Törnkvist, H., Eriksson, K., Söderqvist, A., Ponzer, S., & Tidermark, J. (2007). A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. Journal of Bone and Joint Surgery. British Volume, 89(2), 160–165. doi: 10.1302/0301-620X.89B2.18576. PubMedCrossRef
Berry, D. J., von Knoch, M., Schleck, C. D., & Harmsen, W. S. (2004). The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty. Journal of Bone and Joint Surgery. American Volume, 86(1), 9–14.
Woo, R. Y., & Morrey, B. F. (1982). Dislocations after total hip arthroplasty. Journal of Bone and Joint Surgery. American Volume, 64(9), 1295–1306.
Enocson, A., Tidermark, J., Törnkvist, H., & Lapidus, L. J. (2008). Dislocation of hemiarthroplasty after femoral neck fracture: Better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips. Acta Orthopaedica, 79(2), 211–217. doi: 10.1080/17453670710014996. PubMedCrossRef
Johansson, T., Jacobsson, S. A., Ivarsson, I., Knutsson, A., & Wahlström, O. (2000). Internal fixation versus total hip arthroplasty in the treatment of displaced femoral neck fractures: A prospective randomized study of 100 hips. Acta Orthopaedica Scandinavica, 71(6), 597–602. doi: 10.1080/000164700317362235. PubMedCrossRef
Lu-Yao, G. L., Keller, R. B., Littenberg, B., & Wennberg, J. E. (1994). Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. Journal of Bone and Joint Surgery. American Volume, 76(1), 15–25.
Enocson, A., Hedbeck, C.-J., Tidermark, J., Pettersson, H., Ponzer, S., & Lapidus, L. J. (2009). Dislocation of total hip replacement in patients with fractures of the femoral neck. A prospective cohort study of 713 consecutive hips. Acta Orthopaedica, 80(2), 184–189. doi: 10.3109/17453670902930024. PubMedCrossRef
Garden, R. S. (1961). Low-angle fixation in fractures of the femoral neck. Journal of Bone and Joint Surgery, 43, 647–663.
Baker, R. P., Squires, B., Gargan, M. F., & Bannister, G. C. (2006). Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomized, controlled trial. Journal of Bone and Joint Surgery. American Volume, 88(12), 2583–2589. doi: 10.2106/JBJS.E.01373. CrossRef
- Quality of life after dislocation of hip arthroplasty: a prospective cohort study on 319 patients with femoral neck fractures with a one-year follow-up
- Springer Netherlands