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Risk Factors Associated with Dislocation after Bipolar Hemiarthroplasty in Elderly Patients with Femoral Neck Fracture

김영호|황규태|김이석|김준국|주일한
대한고관절학회 (The Korean Hip Society)|2016.06|Hip and Pelvis|제28권 제2호|pp. 104-111|DOI 10.5371/hp.2016.28.2.104

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키워드

ElderlyRisk factorsDislocationsFemoral neck fracturesHemiarthroplasty

초록

Purpose: We investigated the incidence and time of dislocation and other factors associated with dislocation of bipolar hemiarthroplasty related to the treatment of femoral neck fracture in old age patients. Materials and Methods: Between January 2002 and April 2014, 498 femoral neck fractures (467 patients) were treated with bipolar hemiarthroplasty and included in this study. All surgeries were performed using the posterolateral approach. The incidence of dislocation was investigated. A comparative analysis between a control group and dislocation group was performed with respect to patient factors including age, gender, body mass index, comorbidities, the ASA (American Society of Anesthesiologists) score, mental status and center-edge angle, and surgical factors including type of femoral stem, leg length discrepancy, femoral offset and method of short external rotator (SER) reconstruction. Results: The incidence of dislocation was 3.8%, and the dislocation occurred on average 2.2 months (range, 0.6-6.5 months) after operation. No difference in patient-related factors was observed between the two groups. However, a smaller center edge (CE) angle was observed in the dislocation group (42.1。±3.2。vs. 46.9。±5.4。, P<0.001), and significantly lower incidence of dislocation was observed in tendon to bone repair group (0.7% vs 7.8%, P<0.001). Conclusion: SERs should be repaired using the tendon-to-bone repair method to reduce dislocation rate in elderly patients who undergo bipolar hemiarthroplasty using the postero-lateral approach due to femoral neck fracture. In addition, patients with smaller CE angle should be carefully monitored due to high incidence of dislocation.

Abstract

Purpose: We investigated the incidence and time of dislocation and other factors associated with dislocation of bipolar hemiarthroplasty related to the treatment of femoral neck fracture in old age patients. Materials and Methods: Between January 2002 and April 2014, 498 femoral neck fractures (467 patients) were treated with bipolar hemiarthroplasty and included in this study. All surgeries were performed using the posterolateral approach. The incidence of dislocation was investigated. A comparative analysis between a control group and dislocation group was performed with respect to patient factors including age, gender, body mass index, comorbidities, the ASA (American Society of Anesthesiologists) score, mental status and center-edge angle, and surgical factors including type of femoral stem, leg length discrepancy, femoral offset and method of short external rotator (SER) reconstruction. Results: The incidence of dislocation was 3.8%, and the dislocation occurred on average 2.2 months (range, 0.6-6.5 months) after operation. No difference in patient-related factors was observed between the two groups. However, a smaller center edge (CE) angle was observed in the dislocation group (42.1。±3.2。vs. 46.9。±5.4。, P<0.001), and significantly lower incidence of dislocation was observed in tendon to bone repair group (0.7% vs 7.8%, P<0.001). Conclusion: SERs should be repaired using the tendon-to-bone repair method to reduce dislocation rate in elderly patients who undergo bipolar hemiarthroplasty using the postero-lateral approach due to femoral neck fracture. In addition, patients with smaller CE angle should be carefully monitored due to high incidence of dislocation.

참고문헌 (27)

  1. Klop C, "Mortality in British hip fracture patients, 2000-2010 : a population-based retrospective cohort study", Bone, 66, pp.171~177 (2014)
  2. Brozek W, "Mortality after hip fracture in Austria 2008-2011", Calcif Tissue Int, 95, pp.257~266 (2014)
  3. Turner RS, "Postoperative total hip prosthetic femoral head dislocations. Incidence, etiologic factors, and management", Clin Orthop Relat Res, 301, pp.196~204 (1994)
  4. Moore AT, "The self-locking metal hip prosthesis", J Bone Joint Surg Am, 39-A, pp.811~827 (1957)
  5. Hardinge K, "The direct lateral approach to the hip", J Bone Joint Surg Br, 64, pp.17~19 (1982)
  6. Suh KT, "A posterior approach to primary total hip arthroplasty with soft tissue repair", Clin Orthop Relat Res, 418, pp.162~167 (2004)
  7. Ko CK, "Enhanced soft tissue repair using locking loop stitch after posterior approach for hip hemiarthroplasty", J Arthroplasty, 16, pp.207~211 (2001)
  8. Pellicci PM, "Posterior approach to total hip replacement using enhanced posterior soft tissue repair", Clin Orthop Relat Res, 355, pp.224~228 (1998)
  9. Mukka S, "Dislocation of bipolar hip hemiarthroplasty through a postero-lateral approach for femoral neck fractures : a cohort study", Int Orthop, 39, pp.1277~1282 (2015)
  10. Madanat R, "Dislocation of hip hemiarthroplasty following posterolateral surgical approach : a nested case-control study", Int Orthop, 36, pp.935~940 (2012)
  11. Ninh CC, "Hip dislocation after modular unipolar hemiarthroplasty", J Arthroplasty, 24, pp.768~774 (2009)
  12. Barnes CL, "Dislocation after bipolar hemiarthroplasty of the hip", J Arthroplasty, 10, pp.667~669 (1995)
  13. Bhuller GS, "Use of the giliberty bipolar endoprosthesis in femoral neck fractures", Clin Orthop Relat Res, 162, pp.165~169 (1982)
  14. Petersen MB, "Factors affecting postoperative mortality of patients with displaced femoral neck fracture", Injury, 37, pp.705~711 (2006)
  15. 장준동, "90세 이상 고령의 고관절부 골절 환자에서 시행한 양극성 반치환술 - 사망률에 영향을 준 요인들 -", Hip and Pelvis, 22(4), pp.283~290 (2010), 대한고관절학회
  16. 임채현, "80세 이상 노인의 고관절 골절에서 시행한 인공 고관절 반치환술 - 대퇴골 경부 골절과 전자간 골절의 비교 -", Hip and Pelvis, 25(1), pp.44~50 (2013), 대한고관절학회[DOI]
  17. Alarcón T, "Further experience of nonagenarians with hip fractures", Injury, 32, pp.555~558 (2001)
  18. Ooi LH, "Hip fractures in nonagenarians--a study on operative and non-operative management", Injury, 36, pp.142~147 (2005)
  19. Iorio R, "Surgical treatment of displaced femoral neck fractures in the elderly : a survey of the American Association of Hip and Knee Surgeons", J Arthroplasty, 21, pp.1124~1133 (2006)
  20. Raaymakers EL, "Fractures of the femoral neck : a review and personal statement", Acta Chir Orthop Traumatol Cech, 73, pp.45~59 (2006)
  21. 김성환, "고령의 불안정성 대퇴골 전자간 골절의 치료에 있어 항회전 근위 대퇴 골수정을 이용한 내고정술과 양극성 반치환술의 결과 비교", Hip and Pelvis, 24(1), pp.45~52 (2012), 대한고관절학회
  22. Gregory RJ, "Dislocation after primary arthroplasty for subcapital fracture of the hip. Wide range of movement is a risk factor", J Bone Joint Surg Br, 73, pp.11~12 (1991)
  23. Pajarinen J, "Factors predisposing to dislocation of the Thompson hemiarthroplasty : 22 dislocations in 338patients", Acta Orthop Scand, 74, pp.45~48 (2003)
  24. Weeden SH, "The early dislocation rate in primary total hip arthroplasty following the posterior approach with posterior soft-tissue repair", J Arthroplasty, 18, pp.709~713 (2003)
  25. Seth L. Sherman, "Biomechanical Evaluation of Suture Anchor Versus Transosseous Tunnel Quadriceps Tendon Repair Techniques", Arthroscopy: The Journal of Arthroscopic & Related Surgery, 32(6), pp.1117~1124 (2016), Elsevier BV[DOI]
  26. Enocson A, "Dislocation of hemiarthroplasty after femoral neck fracture : better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips", Acta Orthop, 79, pp.211~217 (2008)
  27. Yoon US, "The treatment of the hip fracture in the dementia patients", J Korean Soc Fract, 12, pp.767~772 (1999)

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