Arthroplasty for femoral neck fractures may reduce mortality, reoperation rates
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SAN DIEGO — Compared with internal fixation of minimally displaced fractures, arthroplasty may reduce the risks of mortality and reoperation in patients with femoral neck fractures, according to a presenter.
“In terms of femoral neck fractures, we know that fracture displacement typically guides treatment,” Gerard Slobogean, MD, MPH, FAAOS, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
To determine the optimal treatment of minimally displaced femoral neck fractures, Slobogean and colleagues analyzed data on 1,441 patients (mean age of 78.8 years) with displaced femoral neck fractures who were treated with arthroplasty and 734 patients (mean age of 74.2 years) with displaced femoral neck fractures who were treated with internal fixation.
Among all patients in the study, the 2-year mortality rate was 15% (n = 327) and the 2-year reoperation rate was 11.4% (n = 248). Slobogean and colleagues found arthroplasty was associated with a reduction in the odds of mortality and the odds of reoperation compared with internal fixation. Additionally, 2-year SF-12 physical component scores were also higher in the arthroplasty cohort compared with the internal fixation cohort.
“Internal fixation may not be the ideal treatment for a lot of femoral neck fractures, including minimally displaced ones,” Slobogean said. “Ultimately, I think we have to continue to consider the pros and cons of our approaches,” he added.
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Slobogean G, et al. Paper 375. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Aug. 31 - Sept. 3, 2021; San Diego.
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