1185 SADHemi Study: A Service Evaluation of Operative Treatment of Dislocated Hip Hemiarthroplasty in the UK – Initial Results
C Brennan, M Haruna, R Simpson, B Kent, R G Middleton- Surgery
Abstract
Aim
Hip hemiarthroplasty is a common orthopaedic procedure for intra-capsular neck of femur fracture. Dislocation is a rare but serious complication with a reportedly high mortality, but the literature and guidance for management is sparse. This study aims to evaluate the prevalence and determine the UK’s current management of dislocated hip hemiarthroplasty.
Method
A national collaborative was established to undertake a retrospective evaluation of patients aged ≥60 years with dislocation of a hip hemiarthroplasty carried out between January 2015 to December 2020. Eligible patients were identified by a site lead at each participating centre and data including patient demographics, management and mortality was entered on to REDCap for analysis.
Results
16 centres have been recruited and 137 patients entered: 65% female; average age 84 years and ASA grade 3. Median time to first dislocation was 22 days. Only 25.9% failed initial closed reduction. 57 patients re-dislocated (45.9%) and of these 64.9% had a successful closed reduction, and 46.4% had further dislocation episodes. Only 20% of patients were still alive at the time data entry.
Conclusions
The initial results show the rate of successful closed reduction of first time dislocation was higher, and the rate of re-dislocation was lower, amongst the SADHemi patients than previously estimated in the limited existing literature. There was more success with second closed reduction than previously reported. Early results suggest a high associated mortality. By expanding the national collaborative to gain more data we hope to further this evaluation and perhaps update the current protocols for management.