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· DOS Abstracts
No dislocations after primary total hip
arthroplasty with the AVANTAGE® dual mobility
cup in Garden Type 3/4 hip fracture patients with
dementia: A retrospective study of 26 procedures.
Anders Elneff Graversen, Mathias Bjerring Ho, Stig Storgaard Jakobsen,
Andrey Kovalev, Pia Kjær Kristensen, Theis Muncholm Thillemann
Department of Orthopedic Surgery, Hospitalsenheden Horsens; Department
of Clinical Epidemiology, Aarhus University Hospital
Background:
The dual mobility cup offers intra-joint stability through a large
diameter mobile liner and large cup-coverage. The dual mobility cup has there-
fore been proposed as a treatment option in patients a high risk of luxation
e.g. dementia, psychiatric disease, neuromuscular disease, and special revision
cases. However, the clinical documentation is still sparse and dislocation rates,
reoperation rates and 30 days mortality in patients with Garden type 3/4 fem-
oral neck fracture and dementia is unknown.
Purpose / Aim of Study:
The aim of this study was to evaluate the dislocation
rates, reoperation rates and 30 day mortality following THA with AVANTAGE®
dual mobility cup in patients with Garden type 3/4 femoral neck fracture and
dementia.
Materials and Methods:
From 2010 to 2014 we retrospectively identified
26 procedures (25 patients) with the AVANTAGE® dual mobility cup in patients
with Garden type 3/4 femoral neck fractures and dementia. Outcome measures
were collected by systematic review of the national medical records The pri-
mary outcome was dislocation. Secondary outcomes were revision surgery, 30
days mortality, surgical delay and in hospital stay. Furthermore, the cup inclina-
tion was determined.
Findings / Results:
Median time of follow-up was 7,9 (0,4-40,4) months.
None of the patients experienced dislocation or received revision surgery. The
30-days mortality rate was 19,2% (5/26). Mean surgical delay was 30,6 hours
(CI 95%: 21,6-39,6) and mean in hospital stay was 7 days (CI 95%: 5,2-8,5).
Conclusions:
THA with the dual-mobility cup seems favourable in the treat-
ment of patients with a displaced femoral neck fracture and dementia. Correct
placement of the cup is pivotal and technically demanding why challenges re-
garding the logistics can be encountered since time to surgery is known to af-
fect the mortality negatively.
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