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The bone & joint journal · Jun 2020
Comparative StudyTreatment of displaced intracapsular fractures of the femoral neck with total hip arthroplasty or hemiarthroplasty.
- Aparna Viswanath, Anum Malik, Warwick Chan, Antonio Klasan, and Neil P Walton.
- North Shore Hospital, Auckland, New Zealand.
- Bone Joint J. 2020 Jun 1; 102-B (6): 693-698.
AimsDespite few good-quality studies on the subject, total hip arthroplasty (THA) is increasingly being performed for displaced intracapsular fractures of the neck of femur. We compared outcomes of all patients with displacement of these fractures treated surgically over a ten-year period in one institution.MethodsA total of 2,721 patients with intracapsular fractures of the femoral neck treated with either a cemented hemiarthroplasty or a THA at a single centre were retrospectively reviewed. The primary outcomes analyzed were readmission for any reason and revision surgery. We secondarily looked at mortality rates.ResultsWe found no difference in the overall revision rate or rate of infection. However, the rates of readmission due to dislocation, pain, and trochanteric bursitis were significantly higher in the THA group (p = 0.001, p < 0.001, p < 0.001, and p = 0.001, respectively).ConclusionOur study, comparing the outcomes of neck of femur fractures treated with a cemented hemiarthroplasty and THA, revealed the perceived superiority of THA was not borne out by our results. This should be carefully considered before any radical change in practice regarding the use of THA for displaced intracapsular fractures of the femoral neck. Cite this article: Bone Joint J 2020;102-B(6):693-698.
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