Abstract：
BACKGROUND: The incidence of hemiarthroplasty dislocation for fracture neck of femurs ranges between 1 and 15% and the one-year mortality is 49- 70%. Revision of hemiarthroplasty to total hip replacement using a constrained liner has shown to improve the morbidity and mortality rates. The aim of the study was to assess whether conversion of dislocated hemiarthroplasty to total hip replacement improve functional and one year mortality.
METHODS: A retrospective analysis of the number of patients who had recurrent dislocations of hemiarthroplasty for fracture neck of femurs were carried out. The data were obtained from NHFD (National Hip Fracture Database) and internal hospital computer systems (Medway, Theatre notes and PACS) between Dec 2008 and Dec 2020. Patient demographics including age, sex, Abbreviated Mental Test Score (AMTS), functional assessment, mortality at one and two years were documented. The risk factors which led to dislocations such as Parkinsons disease, Cerebrovascular accidents, Musculo-neuropathies and Alzheimer`s disease was also noted.
RESULTS: A total of 3994 patients were admitted during the study period of which 1735 (43.4%) patients had hemiarthroplasty. Fifty-six (3.23%) patients had dislocation of hemiarthroplasty. The mean age was 81.4 years (range - 61 to 95). There were 40 (71.4%) females and 16 males (28.6%). The average AMTS score was 5.3. All 56 patients had closed manipulative reduction under anaesthesia within in 12 h of admission. Thirty-one patients (55.4%) went on to have recurrent dislocations of which 18 patients (58.4%) had total hip replacement using captive cup, 6 patients (19.4%) had open reduction,3 patients (9.7%) had excision arthroplasty procedure and four patients (12.5%) had no intervention, Eighteen patients who had total hip replacement with constrained captive for followed up to a minimum of two years (range2- 12 years). There were no intraoperative complications, dislocation or periprosthetic fractures in the follow up period. There was no mortality at the end of two years of follow up in this group, two-year mortality for the patients with alternative management for dislocated hemiarthroplasty was 76.67.
CONCLUSIONS: Treatment of recurrent hemiarthroplasty dislocation by revising to a total hip replacement with a constrained liner gives good functional and mortality outcomes.
METHODS: A retrospective analysis of the number of patients who had recurrent dislocations of hemiarthroplasty for fracture neck of femurs were carried out. The data were obtained from NHFD (National Hip Fracture Database) and internal hospital computer systems (Medway, Theatre notes and PACS) between Dec 2008 and Dec 2020. Patient demographics including age, sex, Abbreviated Mental Test Score (AMTS), functional assessment, mortality at one and two years were documented. The risk factors which led to dislocations such as Parkinsons disease, Cerebrovascular accidents, Musculo-neuropathies and Alzheimer`s disease was also noted.
RESULTS: A total of 3994 patients were admitted during the study period of which 1735 (43.4%) patients had hemiarthroplasty. Fifty-six (3.23%) patients had dislocation of hemiarthroplasty. The mean age was 81.4 years (range - 61 to 95). There were 40 (71.4%) females and 16 males (28.6%). The average AMTS score was 5.3. All 56 patients had closed manipulative reduction under anaesthesia within in 12 h of admission. Thirty-one patients (55.4%) went on to have recurrent dislocations of which 18 patients (58.4%) had total hip replacement using captive cup, 6 patients (19.4%) had open reduction,3 patients (9.7%) had excision arthroplasty procedure and four patients (12.5%) had no intervention, Eighteen patients who had total hip replacement with constrained captive for followed up to a minimum of two years (range2- 12 years). There were no intraoperative complications, dislocation or periprosthetic fractures in the follow up period. There was no mortality at the end of two years of follow up in this group, two-year mortality for the patients with alternative management for dislocated hemiarthroplasty was 76.67.
CONCLUSIONS: Treatment of recurrent hemiarthroplasty dislocation by revising to a total hip replacement with a constrained liner gives good functional and mortality outcomes.
摘要：
背景：股骨颈骨折的半髋关节置换术脱位的发生率在1％至15％之间，一年死亡率为49％至70％。使用限制性衬垫将半髋关节置换术改为全髋关节置换术已显示出可提高发病率和死亡率。该研究的目的是评估脱位半髋关节置换术转换为全髋关节置换术是否可以改善功能和一年死亡率。
方法：对股骨颈骨折半髋关节置换术后复发性脱位的患者人数进行回顾性分析。数据来自NHFD（国家髋部骨折数据库）和医院内部计算机系统（Medway，2008年12月至2020年12月之间的剧院笔记和PACS）。患者人口统计学特征，包括年龄，性别,缩略心理测验评分(AMTS),功能评估，记录了1年和2年的死亡率.导致脱臼的危险因素，如帕金森病，脑血管意外,还注意到肌肉神经病和阿尔茨海默氏病。
结果：在研究期间，共有3994例患者入院，其中1735例（43.4％）患者进行了半髋关节置换术。56例（3.23％）患者发生半髋关节置换术脱位。平均年龄为81.4岁（范围-61至95岁）。女性40例（71.4％），男性16例（28.6％）。AMTS平均得分为5.3。所有56例患者在入院后12小时内在麻醉下进行了封闭式手法复位。31例患者（55.4％）继续发生复发性脱位，其中18例患者（58.4％）使用圈养杯进行了全髋关节置换术，6例患者（19.4%）有切开复位，3例患者（9.7％）进行了关节置换术，4例患者（12.5％）没有干预，18例接受限制性圈养全髋关节置换术的患者随访至少两年（范围2-12年）。术中无并发症,随访期脱位或假体周围骨折。这一组在两年的随访结束时没有死亡，接受半髋关节置换术替代治疗的患者的2年死亡率为76.67.
结论：通过修正为带约束衬垫的全髋关节置换治疗复发性半髋关节置换脱位可获得良好的功能和死亡率结果。
方法：对股骨颈骨折半髋关节置换术后复发性脱位的患者人数进行回顾性分析。数据来自NHFD（国家髋部骨折数据库）和医院内部计算机系统（Medway，2008年12月至2020年12月之间的剧院笔记和PACS）。患者人口统计学特征，包括年龄，性别,缩略心理测验评分(AMTS),功能评估，记录了1年和2年的死亡率.导致脱臼的危险因素，如帕金森病，脑血管意外,还注意到肌肉神经病和阿尔茨海默氏病。
结果：在研究期间，共有3994例患者入院，其中1735例（43.4％）患者进行了半髋关节置换术。56例（3.23％）患者发生半髋关节置换术脱位。平均年龄为81.4岁（范围-61至95岁）。女性40例（71.4％），男性16例（28.6％）。AMTS平均得分为5.3。所有56例患者在入院后12小时内在麻醉下进行了封闭式手法复位。31例患者（55.4％）继续发生复发性脱位，其中18例患者（58.4％）使用圈养杯进行了全髋关节置换术，6例患者（19.4%）有切开复位，3例患者（9.7％）进行了关节置换术，4例患者（12.5％）没有干预，18例接受限制性圈养全髋关节置换术的患者随访至少两年（范围2-12年）。术中无并发症,随访期脱位或假体周围骨折。这一组在两年的随访结束时没有死亡，接受半髋关节置换术替代治疗的患者的2年死亡率为76.67.
结论：通过修正为带约束衬垫的全髋关节置换治疗复发性半髋关节置换脱位可获得良好的功能和死亡率结果。
