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Indian J Orthop. 2019 May-Jun;53(3):402-406. doi: 10.4103/ortho.IJOrtho_255_18.

Efficacy of Different Posterior Capsulotomies on Dislocations in Hip Hemiarthroplasty: T-Shaped Capsulotomy versus Longitudinal Capsulotomy.

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1
Department of Orthopedics and Traumatology, Adana Numune Training and Research Hospital, University of Health Sciences, Adana, Turkey.

Abstract

Background:

Dislocation following hip hemiarthroplasty is one of the leading reasons necessitating a resurgery. Many studies suggested that the type of the surgical approach is the main cause for dislocation. However, no consensus has been reached yet regarding the type of the surgical approach. In this prospective clinical study, we aimed to compare the efficacy of two different capsulotomy techniques on dislocations, applied during hip hemiarthroplasties performed through the posterior approach.

Materials and Methods:

We investigated the dislocation rates in 287 patients (aged 65 and above) who underwent cemented bipolar hemiarthroplasty for displaced femoral neck fractures through the posterior capsular approach using two different capsulotomy techniques between 2009 and 2016. Patients were followed up for 12 months after hemiarthroplasty. Patients were evaluated in two groups; on whom hemiarthroplasty was performed as longitudinal (146 patients) and as T-shaped capsulotomy (141 patients).

Results:

Posterior dislocations occurred in seven (5%) patients who underwent hemiarthroplasty with T-shaped capsulotomy. No dislocation was observed in 146 patients who underwent hip hemiarthroplasty through posterior longitudinal capsulotomy. The difference between the two study groups was statistically significant (P < 0.007).

Conclusion:

Capsule integrity can be achieved through a strong capsule repair which is possible through hemiarthroplasty with longitudinal capsulotomy. Longitudinal capsulotomy is an effective technique in preventing dislocations following hip hemiarthroplasty.

KEYWORDS:

Dislocation; femoral neck fractures; hemiarthroplasty; posterior approach

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