Hemiarthroplasty or total hip arthroplasty for the treatment of a displaced intracapsular fracture in active elderly patients: 12-year follow-up of randomised trial. (February 2017)

• Record Type: Journal Article
• Authors: Tol, M. C. J. M.; van den Bekerom, M. P. J.; Sierevelt, I. N.; Hilverdink, E. F.; Raaymakers, E. L. F. B.; Goslings, J. C.
• Is Part Of: Bone & joint journal. Volume 99B:Number 2(2017)
• Page Start: 250
• Page End: 254
• Publication Date: 2017-02
• Subjects: Hip fractures -- Trauma -- Hemiarthroplasty -- Total hip arthroplasty -- Harris Hip Score; Bones -- Surgery -- Periodicals; Joints -- Surgery -- Periodicals; Orthopedic surgery -- Periodicals; 617.47005
• DOI: 10.1302/0301-620X.99B2.BJJ-2016-0479.R1
• Languages: English
• ISSNs: 2049-4394

Abstract

Abstract : Aims: Our aim was to analyse the long-term functional outcome of two forms of surgical treatment for active patients aged > 70 years with a displaced intracapsular fracture of the femoral neck. Patients were randomised to be treated with either a hemiarthroplasty or a total hip arthroplasty (THA). The outcome five years post-operatively for this cohort has previously been reported. We present the outcome at 12 years post-operatively. Patients and Methods: Initially 252 patients with a mean age of 81.1 years (70.2 to 95.6) were included, of whom 205 (81%) were women. A total of 137 were treated with a cemented hemiarthroplasty and 115 with a cemented THA. At long-term follow-up we analysed the modified Harris Hip Score (HHS), post-operative complications and intra-operative data of the patients who were still alive. Results: At a mean follow-up of 12 years (8.23 to 16.17, standard deviation 2.24), 50 patients (20%), 32 in the hemiarthroplasty group and 18 in the THA group, were still alive, of which 47 (94%) were women. There were no significant differences in the mean modified HHS (p = 0.85), mortality (p = 0.13), complications (p = 0.93) or rate of revision surgery (p = 1.0) between the two groups. Conclusion: In the treatment of active elderly patients with an intracapsular fracture of the hip there is no difference in the functional outcome between hemiarthroplasty and THA treatments at 12 years post-operatively. Cite this article: Bone Joint J 2017;99-B:250–4.