Failure of Closed Reduction After Dislocation of Austin Moore Hemiarthroplasty: An Analysis of Risk Factors A 6-Year Follow-Up Study
ABSTRACT The aim of this study was to determine the factors associated with failure of closed reduction of dislocated Austin Moore hemiarthroplasty for subcapital neck of femur fracture. There were 44 (1.8%) cases of dislocation for a 6-year period. There were 28 females and 12 males, and mean age was 85.6 years. Thirty-two patients (80%) had redislocations, and 13 patients (40%) required 2 or more closed reductions. Twenty-eight patients subsequently had a Girdlestone arthroplasty. Dementia and a previous failed closed reduction were associated with a higher failure rate (P = .03 and .04, respectively). Failed close reduction patients also had a higher 6-month mortality rate (P = .04). Closed reduction after Austin Moore hip dislocation has a higher failure rate significantly in patients with dementia and are associated with a higher mortality rate. We believe closed reduction should be avoided in these groups of patients, and Girdlestone procedure was considered after initial first dislocation.
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ABSTRACT: Dislocating hip prosthesis remains a substantial clinical problem. The aim of this study is to describe the risk of recurrent instability after a primary dislocation of primary hip arthroplasty performed for osteoarthritis (OA) or femoral neck fracture (FNF).International Orthopaedics 11/2014; DOI:10.1007/s00264-014-2583-8 · 2.02 Impact Factor
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ABSTRACT: Dislocation is a frequent and costly complication of hip arthroplasty. The purpose of this study was to assess the financial impact on the treating institution of this complication in patients with primary hemiarthroplasty (HA), total hip arthroplasty (THA) and revision surgery (RTHA). Between October 2001 and August 2009, 2014 consecutive hip arthroplasties were performed at our institution, of which 87 (18 HA, 44 THA and 25 RTHA) dislocated within 6 weeks of the primary operation. The average cost of treating implant dislocation by closed reduction, open reduction or revision was assessed and expressed as a percentage cost increase compared to an uncomplicated procedure. Of the 87 dislocated implants all needed one or more closed reductions and 52 eventually required revision surgery. An early dislocation increased the cost of HA, THA and RTHA by 472%, 342% and 352%, respectively.Hip international: the journal of clinical and experimental research on hip pathology and therapy 01/2012; 22(1):62-7. DOI:10.5301/HIP.2012.9059 · 0.34 Impact Factor
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ABSTRACT: INTRODUCTION Dislocation following hip hemiarthroplasty (HHA), its incidence, predictors, treatment outcomes and mortality were investigated in a single centre series. METHODS The prospectively collected data on neck of femur fracture admissions compiled over 11 years were reviewed. Place of residence, place of fall, past medical history, intraoperative factors (grade of surgeon, delay in surgery, type of implant and operative time), postoperative complications and mortality were compared between patients who suffered a dislocation and those who did not. In the dislocation group, the mean number of dislocations, reduction method, type and fate of implant, and mortality were investigated. RESULTS Prospective data on 8,631 admissions were collected; 41% of these were managed with a HHA. The dislocation rate was 0.76%. A delay in surgery of >24 hours was associated with a fourfold increase in the dislocation risk. The majority (81%) of dislocations occurred in the first six weeks and closed manipulation was the definitive treatment in only 23% of the cases. The mortality rate was not increased following HHA dislocation. CONCLUSIONS The delay in surgery was the most important predictor of HHA dislocation. Closed reduction was associated with a high failure rate. While an initial attempt at closed reduction for a first dislocation is recommended, for redislocators, we recommend early exploration/revision as an alternative to repeat manipulations.Annals of The Royal College of Surgeons of England 09/2014; 96(6):446-451. DOI:10.1308/003588414X13946184903045 · 1.22 Impact Factor