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Is the Dislocation Rate Higher after Bipolar Hemiarthroplasty in Patients with Neuromuscular Diseases?

  • Clinical Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Patients with neuromuscular disease reportedly have a higher incidence of postoperative dislocation after bipolar hemiarthroplasty. Although the literature has focused on a high prevalence of preoperative neurologic conditions in patients who had dislocations after bipolar hemiarthroplasties, the relative incidence of dislocation in patients with neuromuscular disease and without is unclear.

Questions/purposes

We therefore (1) asked whether the incidence of postoperative dislocation after bipolar hemiarthroplasty was greater in patients with neuromuscular disease than for those without, and (2) whether function differed between the two groups, and (3) explored potential risk factors for dislocation in two groups.

Methods

We retrospectively reviewed 190 patients who underwent bipolar hemiarthroplasties for fracture of the femoral neck between 1996 and 2008. Of the 190 patients, 42 had various neuromuscular diseases and 148 had no history of neuromuscular disease. Intraoperative stability was tested and posterior soft tissue repair was performed in all patients. We determined the incidence of dislocation, postoperative leg length discrepancy, and femoral offset in patients with or without neuromuscular disease.

Results

The incidence of dislocation was 2.6% in all patients. We observed similar rates of dislocation in the two groups: 4.8% (two of 42 hips) in patients with neuromuscular disease and 2.0% (three of 148 hips) in patients without neuromuscular disease.

Conclusions

In femoral neck fractures in patients with neuromuscular disease, careful preoperative management and operative technique such as a posterior soft tissue repair might decrease the risk of postoperative dislocation; therefore, we consider the bipolar hemiarthroplasty a reasonable treatment option.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Fig. 2A–D

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Pusan National University School of Medicine, Beomeo-ri, Mulgeum-eup, Yangsan, 626-770, Korea

    Kuen Tak Suh MD, Dae Woong Kim MD, Hong Seok Lee MD, Yoon Jae Seong MD & Jung Sub Lee MD

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  1. Kuen Tak Suh MD
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  2. Dae Woong Kim MD
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  3. Hong Seok Lee MD
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  4. Yoon Jae Seong MD
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Correspondence to Kuen Tak Suh MD.

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Each author certifies that he has no commercial association (eg, consultancies, stock ownership, equity interest, patent, licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his institution has approved the human use protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for clinical participation in the study was obtained.

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Suh, K.T., Kim, D.W., Lee, H.S. et al. Is the Dislocation Rate Higher after Bipolar Hemiarthroplasty in Patients with Neuromuscular Diseases?. Clin Orthop Relat Res 470, 1158–1164 (2012). https://doi.org/10.1007/s11999-011-2139-9

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  • DOI: https://doi.org/10.1007/s11999-011-2139-9

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