Dislocation of hemiarthroplasty after femoral neck fracture: Better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips

Figures & data

Table 1.  Baseline data for all patients included, in relation to surgical approach (n = 739)

	All	A-L	P-L
	(n = 739)	(n = 431)	(n = 308)
Age, mean (SD)	84 (7.2)	84 (7.4)	85 (6.9)
Sex, n (%)
Female	592 (80)	337 (78)	255 (83)
Male	147(20)	94 (22)	53(17)
Indication, n (%)
Primary	457 (62)	330 (77)	127 (41)
Secondary	282 (38)	101 (23)	181 (59)
Surgeon's experience, n (%)
Registrar	135 (18)	98 (23)	37 (12)
Post-registrar	604 (82)	333 (77)	271 (88)
Type of HA, n (%)
Austin Moore	389 (53)	121 (28)	268 (87)
Exeter Unipolar	127 (17)	117 (27)	10 (3)
Exeter Bipolar	223 (30)	193 (45)	30 (10)

A-L: anterolateral; P-L: posterolateral; HA: hemiarthro-plasty.

Table 2.  Incidence of prosthetic dislocations

	Dislocation	No dislocation	P-value
	(n = 45)	(n = 694)
Age, mean (SD)	82.5 (7.4)	84.2 (7.2)	0.08
Sex, n (%)
Female	39 (7)	553 (93)	0.3
Male	6 (4)	141 (96)
Indication, n (%)
Primary	23 (5)	434 (95)	0.1
Secondary	22 (8)	260 (92)
Surgeon's experience, n (%)
Registrar	8 (6)	127 (94)	0.9
Post-registrar	37 (6)	567 (94)
Type of HA, n (%)
Austin Moore	29 (8)	360 (92)	0.06
Exeter Unipolar	2 (2)	125 (98)
Exeter Bipolar	14 (6)	209 (94)
Surgical approach, n (%)
A-L	13 (3)	418 (97)	< 0.001
P-L^a with repair	15 (9)	161 (91)
P-L^a no repair	17 (13)	112 (87)

HA, A-L, and P-L: see Table 1.

^a3 values are missing regarding information on posterior repair.

Table 3. Logistic regression to evaluate factors associated with prosthetic dislocation (n = 739, except in the univariate analysis of surgical approaches and all multivariate analyses due to 3 missing values regarding information on posterior repair)

Explanatory	Univariate		Multivariate
	OR ^a (95%CI ^b)	P-value	OR^a(95%CI^b)	P-value
≥ 85 years	0.6 (0.3–1.2)	0.1	0.6(0.3–1.1)	0.1
Sex (Male ref.^c)
Female	1.7(0.7–4.0)	0.3	1.5 (0.6–3.7)	0.4
Indication (Primary ref.^c)
Secondary	1.6(0.9–2.9)	0.1	1.0 (0.5–2.0)	0.9
Surgeon's experience (Registrar ref.^c)
Post-registrar	1.0 (0.4–2.2)	0.9	1.3 (0.6–3.0)	0.5
Type of HA (Austin-Moore ref. ^c)
Exeter Unipolar	0.2 (0.5–0.8)	0.03	0.6(0.1–3.1)	0.6
Exeter Bipolar	0.8 (0.4–1.6)	0.6	2.1 (0.9–4.9)	0.1
Surgical approach (A-L ref.^c)
P-L with repair	3.0 (1.4–6.4)	0.005	3.9(1.6–9.8)	0.003
P-L no repair	4.9(2.3–10)	< 0.001	6.9(2.6–19)	< 0.001

HA, A-L, and P-L: see Table 1.

^aOR = Odds ratio.

^b 95%CI = 95% confidence interval.

Outcome in patients with dislocation (n = 45).