• Tilman Graulich, Pascal Graeff, Ashish Jaiman, Stine Nicolaides, Tarek Omar Pacha, Marcus Örgel, Christian Macke, Mohamed Omar, Christian Krettek, and Emmanouil Liodakis.
• Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany. graulich.tilman@mh-hannover.de.
• Eur J Orthop Surg Tr. 2021 May 1; 31 (4): 627-633.

PurposeBipolar hemiarthroplasty has been shown to have a lower rate of dislocation than total hip arthroplasty. However, as the influencing risk factors for bipolar hemiarthroplasty dislocation remain unclear, we aimed to analyse patient and surgeon-specific influencing risk factors for bipolar hemiarthroplasty dislocation.MethodsWe retrospectively analysed patients who were operated between 2012 and 2018 and had dislocated bipolar hemiarthroplasty and matched them to patients without a dislocated bipolar hemiarthroplasty, operated between 2018 and 2019. The study was limited to patients who received either a pre- or postoperative pelvic computed tomography. Besides demographic, morphologic, and physiologic data, we analysed duration of surgery; ASA score; Charlson Comorbidity Index; Almelo Hip Fracture Score; Parker Score; and acetabular morphology angles including acetabular anteversion angle, posterior acetabular sector angle, posterior wall angle, and acetabular roofing.ResultsWe included nine patients with a dislocated bipolar hemiarthroplasty and 30 with a non-dislocated bipolar hemiarthroplasty. Patient-specific factors prompting a higher risk for dislocated bipolar hemiarthroplasty were longer duration of surgery (min) (115 ± 50 vs. 80 ± 27, p = 0.01); dementia (56% vs. 13%, p < 0.01); smaller posterior acetabular sector angle (°) (96 ± 6 vs. 109 ± 10, p < 0.01); and smaller posterior wall angle (°) (67 ± 6 vs. 77 ± 10, p = 0.02).ConclusionDementia and insufficient posterior wall angle were associated with higher risk of dislocation in bipolar hemiarthroplasty.

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