Can We Minimize Hip Dislocation with Optimal Patient Selection and Modern Surgical Technique?
Stéphane Leduc, MD (*); Joseph Borrelli, MD (*); William M. Ricci, MD (a,e-Smith & Nephew); Washington University School of Medicine, St. Louis, Missouri, USA Purpose: Recent randomized trials have demonstrated that primary total hip arthroplasty (THA) is superior to internal fixation for displaced femoral neck fracture in the active and lucid elderly patient. However, compared to hemiarthroplasty, THA has historically been associated with an unacceptably high dislocation rate (10-20%), diminishing enthusiasm for THA in this patient population. We hypothesized that proper patient selection combined with modern surgical technique and implants would reduce the short-term dislocation rate for patients treated for acute displaced femoral neck fracture with THA. Methods: Between June 1999 and June 2005, 25 patients (15 females and 10 males) with a mean age of 73 years were treated by two surgeons at one institution with a THA for an acute displaced femoral neck fracture (OTA31B). Patients w
