75% of the task) and (2) a disease leading to poor motor control. Exclusion criteria were normal muscular control and known infection of the involved joint.RESULTS: Of the 354 patients, 87 fulfilled the inclusion criteria and underwent constrained total hip. Average age was 78 years with a female predominance (73%). Fifteen patients had prior hemiparesis, 19 had Parkinson disease, and 35 had generalized sarcopenia. Eighty-five patients had an uneventful recovery, with an average Hip Disability and Osteoarthritis Outcome Score (HOOS) of 76 ± 7 at 2 years. In 2 patients, the prostheses dislocated. In both cases, the dislocation was due to ring displacement and the inner head dislocated. One case was infected and the patient was treated by a Girdlestone procedure. In the other case, the prosthetic head was revised. The patient remained asymptomatic and at 4-year follow-up had an HOOS of 85.DISCUSSION: It appears that constrained prosthesis is a suitable treatment for patients with poor muscular control having subcapital fractures. The functional results appear to be superior to those of bipolar arthroplasty and similar to the results of primary total hip arthroplasty while the dislocation risk is " />
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Yassin M, Garti A, Khatib M, et al. Retentive Cup Arthroplasty in Selected Hip Fracture Patients-A Prospective Series With a Minimum 3-Year Follow-Up. Geriatr Orthop Surg Rehabil. 2016;7(4):178-182doi: 10.1177/2151458516661384.
Yassin, M., Garti, A., Khatib, M., Weisbrot, M., & Robinson, D. (2016). Retentive Cup Arthroplasty in Selected Hip Fracture Patients-A Prospective Series With a Minimum 3-Year Follow-Up. Geriatric orthopaedic surgery & rehabilitation, 7(4), 178-182. https://doi.org/10.1177/2151458516661384
Yassin, Mustafa, et al. "Retentive Cup Arthroplasty in Selected Hip Fracture Patients-A Prospective Series With a Minimum 3-Year Follow-Up." Geriatric orthopaedic surgery & rehabilitation vol. 7,4 (2016): 178-182. doi: https://doi.org/10.1177/2151458516661384
Yassin M, Garti A, Khatib M, Weisbrot M, Robinson D. Retentive Cup Arthroplasty in Selected Hip Fracture Patients-A Prospective Series With a Minimum 3-Year Follow-Up. Geriatr Orthop Surg Rehabil. 2016 Dec;7(4):178-182. doi: 10.1177/2151458516661384. Epub 2016 Aug 08. PMID: 27847676; PMCID: PMC5098687.
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Geriatr Orthop Surg Rehabil. 2016 Dec;7(4):178-182. doi: 10.1177/2151458516661384. Epub 2016 Aug 08.

Retentive Cup Arthroplasty in Selected Hip Fracture Patients-A Prospective Series With a Minimum 3-Year Follow-Up.

Geriatric orthopaedic surgery & rehabilitation

Mustafa Yassin, Avraham Garti, Muhammad Khatib, Moshe Weisbrot, Dror Robinson

Affiliations

  1. Department of Orthopedic Surgery, Rabin Medical Center, Hasharon Hospital, Tel Aviv University Medical School, Petah Tikva, Israel.

PMID: 27847676 PMCID: PMC5098687 DOI: 10.1177/2151458516661384

Abstract

OBJECTIVE: To evaluate the efficacy of the use of retentive cup primary total hip replacement (THR) in high-dislocation risk subcapital fracture patients.

METHODS: During the years 2008 to 2012, 354 patients with displaced subcapital fracture were operated at our institute. The patients were selected to undergo primary constrained THR according to the following criteria: (1) a preinjury grade 4 or more on the Functional Independence Measure mobility item "5. Locomotion: walking/wheelchair" and grade 4 is defined as "4. Minimal assistance Requiring incidental hands-on help only" (patient performs >75% of the task) and (2) a disease leading to poor motor control. Exclusion criteria were normal muscular control and known infection of the involved joint.

RESULTS: Of the 354 patients, 87 fulfilled the inclusion criteria and underwent constrained total hip. Average age was 78 years with a female predominance (73%). Fifteen patients had prior hemiparesis, 19 had Parkinson disease, and 35 had generalized sarcopenia. Eighty-five patients had an uneventful recovery, with an average Hip Disability and Osteoarthritis Outcome Score (HOOS) of 76 ± 7 at 2 years. In 2 patients, the prostheses dislocated. In both cases, the dislocation was due to ring displacement and the inner head dislocated. One case was infected and the patient was treated by a Girdlestone procedure. In the other case, the prosthetic head was revised. The patient remained asymptomatic and at 4-year follow-up had an HOOS of 85.

DISCUSSION: It appears that constrained prosthesis is a suitable treatment for patients with poor muscular control having subcapital fractures. The functional results appear to be superior to those of bipolar arthroplasty and similar to the results of primary total hip arthroplasty while the dislocation risk is <3%.

CONCLUSION: Semielective total hip arthroplasty using a retentive cup liner appears to offer good functional results with a low dislocation rate in patients with poor muscular control.

Keywords: adult reconstructive surgery; dementia; fragility fractures; geriatric medicine; geriatric trauma; osteoporosis

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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