Outcomes of the dislocated hip hemiarthroplasty: a multi-centre study

Area of Science:

• Orthopedic Surgery
• Arthroplasty Research
• Geriatric Hip Fracture Management

Background:

• Hip hemiarthroplasty is a common procedure for displaced intracapsular hip fractures in frail patients.
• Dislocations following hip hemiarthroplasty occur in 0.6-5.0% of cases and are linked to increased mortality.
• This study evaluates outcomes of managing dislocated hip hemiarthroplasties and associated 1-year mortality.

Purpose of the Study:

• To quantify outcomes for managing dislocated hip hemiarthroplasties.
• To assess the 1-year mortality associated with hip hemiarthroplasty dislocations.
• To evaluate the efficacy of different management strategies for hip hemiarthroplasty dislocations.

Main Methods:

• Retrospective review of 4116 cemented hip hemiarthroplasties.
• Identified 63 cases of hemiarthroplasty dislocation.
• Analyzed outcomes of closed reduction attempts and revision arthroplasty, including 1-year mortality.

Main Results:

• Closed reduction failed in 72% of first dislocations, 76.9% of second, and 100% of third attempts.
• The overall 1-year mortality rate after dislocation was 46.0%.
• Revision arthroplasty showed the lowest 1-year mortality rate (27.3%).

Conclusions:

• Closed reduction of dislocated hip hemiarthroplasty has a high failure rate, increasing with subsequent dislocations.
• Revision procedures should be considered after a second dislocation, especially with suspected soft tissue failure or infection.
• Management strategies for dislocated hip hemiarthroplasty require careful consideration to minimize patient mortality.