title: Do Dual-Mobility Cups Reduce the Risk of Dislocation in Total Hip Arthroplasty for Fractured Neck of Femur in Patients Aged Older Than 75 Years?
abstract: Total hip arthroplasty (THA) for intracapsular neck of femur (NOF) fracture remains debatable as it is associated with higher rates of dislocation, notably in the older part of the population. We hypothesized this risk could be limited using dual-mobility cups (DMCs).
  
  
  
  Eighty-two patients (83 hips) aged older than 75 years underwent DMC-THA using a posterolateral approach for an intracapsular NOF fracture.
  
  
  
  Clinical data were collected in 45 patients at a mean of 23.8 ± 9.4 months (12.1-42 months). The mortality rates were 19% (16 patients) and 36.5% (30 patients) at 1 year postoperatively and at the last follow-up, respectively. Postoperatively, there were 2 dislocations of the large articulation (4.4%) and one intraprosthetic dislocation (2.2%), all related to technical errors. Functional results were rated at least good in 71% cases, whereas the Parker and Devane scores were stable, indicating optimal restoration of autonomy and physical activity.
  
  
  
  Although technically demanding, DMC-THA may prevent dislocation in intracapsular NOF fracture in elderly patients, while consistently limiting the risk of loss of independence.
authors.affiliation: Department of Traumatology and Orthopaedic Surgery, European Hospital of Paris, Medical school Paris 5, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Nich
authors.affiliation: Department of Traumatology and Orthopaedic Surgery, European Hospital of Paris, Medical school Paris 5, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Vandenbussche
authors.affiliation: Department of Traumatology and Orthopaedic Surgery, European Hospital of Paris, Medical school Paris 5, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Augereau
authors.affiliation: Department of Traumatology and Orthopaedic Surgery, European Hospital of Paris, Medical school Paris 5, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Sadaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005269:Femur / Q000601:surgery*; D006617:Hip Dislocation / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011475:Prosthesis Failure; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: dislocation; dual-mobility cup; elderly; fracture; neck of femur; total hip arthroplasty