One in 10 patients with surgically treated hip fractures converted to THA within 5 years
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According to published results, one in 10 patients aged 60 years or older who were treated with internal fixation for a nondisplaced femoral neck fracture underwent conversion to total hip arthroplasty within 5 years.
Researchers used the Swedish Arthroplasty Register to analyze data for 5,428 patients (mean age of 81 years) who underwent internal fixation of nondisplaced femoral neck fracture between Jan. 1, 2012, and Dec. 31, 2018. According to the study, 57.2% of fractures were fixated with hook pins and 38.4% were fixated with screws. Outcome measures included conversion rates to THA and mortality, which was assessed at 1, 2 and 5 years.
Researchers found cumulative incidence function for conversion to THA was 6.3% within the first year, 8.1% within 2 years and 10.1% within 5 years. At 2 years, conversion rates were 6.5% in patients aged 60 to 69 years, 9.6% in patients aged 70 to 79 years and 7.8% in patients aged 80 years or older. Researchers noted women had a higher risk of conversion to THA compared with men (hazard ratio [HR] = 1.49), specifically women who were aged 70 to 79 years had the highest risk for conversion of all groups.
Cumulative mortality was 21.3% within the first year, 31.3% within 2 years and 54.9% within 5 years. According to the study, men had a higher risk of mortality at all time points compared with women (HR = 1.79).
“Selecting arthroplasty as the primary treatment could allow faster mobilization and could potentially decrease morbidity and mortality after the surgical procedure, although the difference in mortality between internal fixation and arthroplasty is not clear in the literature,” the researchers wrote in the study.
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