关键词: Demencia Dementia Doble movilidad Dual mobility Fractura de cadera Hip fracture Inestabilidad Instability Older population Paciente añoso

Mesh : Aged, 80 and over Arthroplasty, Replacement, Hip Female France Hip Dislocation / epidemiology etiology Hip Fractures / complications surgery Hip Prosthesis Humans Male Postoperative Complications / epidemiology etiology Prospective Studies Prosthesis Design Risk Assessment

来  源:   DOI:10.1016/j.recot.2020.03.003

Abstract:
OBJECTIVE: Actually there is a controversy about the treatment of hip fractures on older patients with high risk of dislocation. Our study is focused on report clinico-functional and radiographic results in this population treated with total hip replacement using a dual mobility system after a minimum follow up of 2 years.
METHODS: In the period from January 2015 to January 2016 patients assisted at the Emergency Unit at the participant hospital were recluted for participation. A total of 137 patients were assisted and 41 fulfilled the inclusion criteria and accepted to participate. All patients received a total hip replacement with a dual mobility system (cemented or uncemented). The patients were evaluated with the Mini-Mental State Examination, walking distance test, preop and postop at 3 and 6 weeks, 3 months, 6 months, one year and subsequent years. Radiographic evaluation was scheduled with clinico-functional review.
RESULTS: Forty-one patients included, follow up average 2.4 years (range 2 to 3.2 years). Mean age 85.2 (range 80 to 96 years). Four patients died during follow up due to causes not related to the total hip replacement and the implant was functioning. One case have an infection and was revised in one stage procedure. One case have an infection at 8 months follow-up and was revised in one stage procedure. There were no dislocations.
CONCLUSIONS: The use of dual mobility system in this high dislocation risk population has shown good clinical and functional results, and support the sistematic indication in our services.
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