• Injury · Nov 2019

    Randomized Controlled Trial Comparative Study

    Treatment of the displaced intracapsular fracture for the 'fitter' elderly patients: A randomised trial of total hip arthroplasty versus hemiarthroplasty for 105 patients.

    • Martyn J Parker and Shirley Cawley.
    • Department of Orthopaedics, Peterborough City Hospital, Peterborough and Stamford Hospital NHS Foundation Trust, Bretton Gate, Peterborough PE3 9GZ, England, United Kingdom. Electronic address: Martyn.parker1@nhs.net.
    • Injury. 2019 Nov 1; 50 (11): 2009-2013.

    AbstractControversy exists for the optimum method of surgical treatment for the 'fitter' elderly patient with a displaced intracapsular fracture. 105 patients were randomised to treatment with either a cemented polished tapered stem hemiarthroplasty or a cemented total hip arthroplasty (THR) with a cemented acetabular cup. All patients were followed up for a minimum of one year using a blinded assessment of functional outcome. Those patients treated with a THR had a tendency to a longer hospital stay and increased medical (12 versus 62) and surgical complications (4 versus 2) in comparison to those treated by hemiarthroplasty. Mean operative times (842 versus 52 min) and operative blood loss (335mls versus 244mls) were increased for THR. Final outcome measures of residual pain and regain of function were similar for both methods of treatment. We recommend that caution should be exercised regarding the increased promotion of THR for intracapsular hip fractures until further studies are completed.Copyright © 2019 Elsevier Ltd. All rights reserved.

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