THA associated with increased short-term risk for hip dislocation vs. hemiarthroplasty
Compared with patients who undergo hip hemiarthroplasty for a femoral neck fracture, patients who undergo total hip arthroplasty are at increased risk for hip dislocations at 30 days, 1 year and 2 years after surgery, according to a study.
Mina Tohidi, MD, PhD, FRCSC, and colleagues at Queen’s University in Kingston, Ontario, Canada, performed a propensity-score matched cohort study of patients aged 60 years or older who underwent THA (n = 4,612) or hip hemiarthroplasty (n = 9,224) for a femoral neck fracture from 2002 and 2017. According to the study, outcome measures included hip dislocation, revision, readmission and mortality.
Compared with hemiarthroplasty, THA was associated with an increased risk for hip dislocation at 30 days (0.5% vs. 1%, respectively), 1 year (0.7% vs. 1.7%) and 2 years (0.8% vs. 1.8%) after surgery. They also noted most hip dislocations occurred within the first 4 months.
Tohidi and colleagues found no significant differences between the cohorts in revision rates up to 10 years postoperatively or readmission rates up to 30 days postoperatively; however, they noted mortality risk was lower at 1 year and 2 years postoperatively for patients who underwent THA.
“In the real world, neither treatment was found to be definitively better than the other,” the researchers wrote in the study. “Shared decision-making with patients and families is encouraged, and discussion of both short- and long-term risks may be helpful when selecting the most appropriate treatment for each patient.”
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