Dual mobility cup in hip fracture: Indications and clinical results compared with bipolar hip arthroplasty.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest Pietro Ruggieri is Consultant and Designer for Stryker and Exactech. Each Author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. 12. J Arthroplasty. 2021 Jun;36(6):2049-2054.e5. doi: 10.1016/j.arth.2021.02.004. Epub 2021 Feb 6. Risks and Complications After Arthroplasty for Pathological or Impending Pathological Fracture of the Hip. Boddapati V(1), Held MB(1), Levitsky M(1), Charette RS(1), Neuwirth AL(1), Geller JA(1). Author information: (1)Department of Orthopaedic Surgery, New York-Presbyterian/Columbia University Irving Medical Center, New York, NY. BACKGROUND: Treatment options for metastatic osseous lesions of the proximal femur include hemiarthroplasty (HA) or total hip arthroplasty (THA) depending on lesion characteristics and patient demographics. Studies assessing short-term outcomes after HA/THA in this patient population are limited. Therefore, the purpose of this present study was to identify short-term rates of morbidity and mortality after HA/THA for pathological proximal femur fractures, as well as readmission and reoperation rates and reasons. METHODS: This study utilized a large, prospectively collected registry to identify patients who underwent HA/THA between 2011 and 2018. Patients were stratified by indication for surgery, including pathological fracture, nonpathological fracture, and osteoarthritis. Baseline patient characteristics and postoperative complications were compared using bivariate and/or multivariate analysis. RESULTS: In total, 883 patients undergoing HA/THA for a pathological fracture were identified. Relative to an osteoarthritis cohort, these patients tended to be older, had a lower body mass index, and had significantly more preoperative comorbidities. These patients had high rates of total complications (13.93%), including thirty-day mortality (3.29%), unplanned return to the operating room (4.98%), and pulmonary complications (3.85%). Patients with pathological fracture had a longer operative duration relative to osteoarthritis and nonpathological cohorts (+27 and +25 minutes, respectively), despite having high rates of HAs performed. CONCLUSION: Patients undergoing hip arthroplasty for pathologic proximal femur fracture have increased morbidity and mortality relative to an osteoarthritis cohort. However, patients with a pathological fracture have similar rates of morbidity and mortality when compared with a nonpathological fracture cohort, but did experience higher rates of perioperative blood transfusion and unplanned readmissions. LEVEL OF EVIDENCE: III. Copyright © 2021 Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2021.02.004