Abstract
Introduction
The rapidly expanding aging population in the UK are living longer than ever before, which is reflected by the rising number of relatively fit and healthy people that sustain fracture NOF (neck of femur). According to current NICE (National institute for health clinical excellence) guidelines a large proportion of fracture NOF patients meet the requirements to have a total hip arthroplasty (THA) for this injury. Dislocation rate of THA can be as high as 20% for patients with fracture NOF, which is a disastrous complication in these vulnerable patients. Numerous techniques have been adopted to minimise the risk of dislocation. The use of dual mobility (tripolar) acetabular components is one such strategy with a proven track record in the literature that is employed by surgeons at our institute.
Objectives
To assess the dislocation rate in patients with fracture NOF treated with dual mobility (tripolar) THAs in our unit.
Method
Retrospective study analyzing clinical notes and radiographs for dislocation rate, cup inclination, and limb length discrepancy.
Results
A total of 17 patients with fracture NOF were treated with biarticular THAs during a 3½ year study period, with an average follow up of 22 months. Mean cup inclination was 42°, with mean limb length discrepancy of 3.4 mm. All patients mobilized comfortably without the use of walking aids. There have been no dislocations in our study group to date.
Conclusions
This small series has excellent results, with a 0% dislocation rate, in treating fracture NOF patients with dual mobility (tripolar) acetabular cups. This is comparable to larger studies in the literature. Dual mobility cups provide a valuable option to decrease dislocation risk without increasing polyethylene wear rate. This is a safe, effective technique with a proven advantage to reduce dislocation risk in patients undergoing THA for fracture NOF.
