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Similar complication rates seen with THA vs. hemiarthroplasty for femoral neck fractures
The results of a recently presented study showed similar complication and revision rates among patients who underwent either total hip arthroplasty or hemiarthroplasty for displaced femoral neck fractures.
Hemiarthroplasty has traditionally been the surgical method of choice for patients with displaced femoral neck fractures. Although recent studies have suggested that total hip arthroplasty (THA) results in superior outcomes, concern exists that the risk of complications is higher among patients who undergo THA than those who undergo hemiarthroplasty, according to lead researcher Nelson F. SooHoo, MD, associate professor in the Department of Orthopedic Surgery at the University of California, Los Angeles.
“This has been the subject of great debate in recent literature,” SooHoo, who is also an Orthopedics Today Editorial Board member, said. “Our results suggest that the added risk of complications from total hip arthroplasty may be small, which would support its use as an alternative to hemiarthroplasty for hip fractures.”
SooHoo and colleagues analyzed population-based discharge data from 40,807 patients with femoral neck fractures who underwent either THA or hemiarthroplasty in California from 1995 to 2005.
The investigators evaluated the rates of short-term complications and mid-term revision surgeries after hemiarthroplasty and THA, and compared the results in effort to determine the optimal surgical treatment.
Using data attained from California’s Office of Health Planning and Development, they identified 2,437 patients who underwent THA and 38,328 who received hemiarthroplasty.
Complications, revision evaluated
At 90-days postoperatively, the researchers found that patients who underwent THA did not have a statistically significant increase in short-term complication risks compared with patients who underwent hemiarthroplasty. These findings were controlled for age, gender, Charlson comorbidity score, race/ethnicity and provider variables such as hospital volume and teaching status.
SooHoo and colleagues evaluated revision rates at 1 year and 5 years postoperatively and did not find statistically significant differences between the surgical methods. In addition, patients who underwent THA had a slightly decreased mortality risk, according to SooHoo.
Both are safe alternatives
Patient factors played a more significant role in influencing short-term rates of complication and mortality than whether THA or hemiarthroplasty was performed, the researchers wrote in their abstract.
“This study demonstrates similar short-term complication and mid-term revision risks following hemiarthroplasty and total hip arthroplasty for hip fractures,” SooHoo said during his presentation at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. “This suggests that both procedures are safe alternatives, but further study is needed to clarify differences in functional outcomes and long-term revision rates for patients undergoing these procedures following hip fracture.” – by Tara Grassia
Reference:
- SooHoo NF. Complication rates of total hip arthoplasty versus hemiarthoplasty for femoral neck fractures. Paper #039. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons; Feb. 15-19; San Diego.
- Nelson F. SooHoo, MD, can be reached at the University of California Los Angeles Department of Orthopedic Surgery, 10945 Le Conte Ave #3355 Los Angeles, CA 90095; 310-267-5299; email: nsoohoo@mednet.ucla.edu.
- Disclosure: SooHoo has no relevant financial disclosures.