Comparative Outcomes of Dual Mobility Cup versus Bipolar Hemiarthroplasty in Patients with Neurological Disorder with Femoral Neck Fractures
Year: 2025
Type: article
Study design: Observational Study
Abstract: Purpose: Purpose: To compare the risk of periprosthetic and medical complications following dual mobility cup total hip arthroplasty (DMC-THA) and bipolar hemiarthroplasty (BHA) for femoral neck fractures in patients with neurological disorders.Materials and Methods: Materials and Methods: This retrospective study included patients with neurological disorders who underwent DMC-THA (n=1,153) or BHA (n=4,612) between 2016 and 2022, identified from the Korean Health Insurance Review and Assessment Service database.Propensity score matching was performed at a 1:4 ratio to adjust for baseline characteristics.The primary outcome was periprosthetic complications; the secondary outcome was medical complications.Results: Results: Compared with the BHA-matched group, the DMC-THA group showed a higher rate of early periprosthetic fracture (2.6% vs. 1.4%,P=0.02) and late dislocation (1.1% vs. 0.5%, P=0.03).No significant differences were observed in periprosthetic joint infection or revision.Regarding medical complications, DMC-THA was associated with more transfusions (63.1% vs. 57.6%,P<0.001) but fewer urinary tract infections (3.4% vs. 5.1%, P=0.01).Multivariable analysis identified DMC-THA as an independent risk factor for early periprosthetic fracture (odds ratio [OR] 3.01, 95% confidence interval [CI] 1.39-6.80,P=0.004) and late dislocation (OR 2.53, 95% CI 1.18-5.42,P=0.02).Conclusion: Conclusion: DMC-THA was not superior to BHA in preventing dislocation and was associated with a higher risk of periprosthetic fracture and late dislocation in neurologically impaired patients.Surgeons should recognize the risks of using DMC-THA implants as a sole strategy to prevent instability in this high-risk population.
Source: Hip & Pelvis
Authors: Seok Ha Hong, Seung Beom Han
Institution: Korea University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413897612