The main criteria for predicting dislocation of the endoprosthesis head in patients with femoral neck fractures after unipolar hip arthroplasty

V.A. Filippenko, V.O. Tankut, V.A. Kolesnichenko, V.O. Mezentsev, O.M. Ovchynnikov

Abstract


Background. The purpose was to determine the main quantitative criteria for predicting dislocation of the implant head of the hip joint in patients with femoral neck fractures with unipolar arthroplasty on the basis of retrospective and prospective analyses of treatment outcomes. Materials and methods. A retrospective analysis of protocols of clinical and radiological examination in 20 patients (5 men, 15 women, aged 55–86 years) with femoral neck fractures after unipolar hip arthroplasty using standard technique was carried out in 2000–2015, as well as a prospective study of the results of applying a new method of unipolar hip arthroplasty with preservation of the joint capsule (Patent of Ukraine No. 119611) in 11 patients (4 men, 7 women, aged 66 to 92 years) with femoral neck fractures, who underwent treatment in 2013–2016. All patients were observed at the State Institution “Sytenko Institute of Spine and Joint Pathology of the Academy of Medical Science of Ukraine”. Results. The main risk factors of endoprosthetic head dislocation after unipolar hip arthroplasty for femoral neck fractures are: old age (90.0 %), weakness of the muscles surrounding the hip joint (90.0 %), excessive movement in the joint in the postoperative period (80.0 %), previous surgery on the hip joint (70.0 %), overweight (60.0 %). The numerical values of prognostic factors and their information value for possible patient-, implant- and surgery-related risk factors for dislocation of the implant head were determined in these patients. Conclusions. The proposed method for the prevention and treatment of dislocation of the implant head by preserving the capsule of the hip joint during primary unipolar hip arthroplasty in patients with femoral neck fractures provides a favorable outcome of surgical treatment, despite the presence of risk factors for dislocation of the implant head in the postoperative period.


Keywords


femoral neck fracture; unipolar hip arthroplasty; dislocation of the implant head; risk factors; prediction

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DOI: https://doi.org/10.22141/1608-1706.1.19.2018.126670

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