Introduction: The treatment of femoral neck fractures may affect the postoperative functional outcome in the elderly. Objectives: This comparative prospective study was carried out to evaluate the outcome of total hip arthroplasty (THA) versus hemiarthroplasty for femoral neck fractures. Methods: We selected 80 patients (17 males and 63 females) who underwent hemiarthroplasty (40 cases; mean age 74,0 ± 5.5 years) or THA (40 cases; mean age 71,4 ± 6.5 years) for a femoral neck fracture at our Institutions between January 2011 and April 2012. These two therapeutic groups were carefully matched for their preoperative characteristics including age, gender, body mass index, ASA class, comorbidities (CIRS score), cognitive function (MMSE). Four- and twelve-month mortality, walking ability, and activities of daily living (ADL Index) were prospectively assessed in the two groups. Hip-related and general complications also were specifically noted. Models of multiple regression analysis were constructed to evaluate the effect of the surgical treatment (hemiarthroplasty or THA) on functional outcomes and mortality. Results: The mortality at 4 and 12 months was not significantly different in the two therapeutic groups. The walking ability at 4 months (P<0.05) and the ADL score at 4 months (P<0.01) and one year (P = 0.01) was superior in patients with THA as compared to those who underwent hemiarthroplasty. The pre-fracture functional level (P<0.001) and the use of THA versus hemiarthroplasty (P = 0.01) represented strong predictors of the four-month ambulatory activity and ADL Index. The use of THA versus hemiarthroplasty was not associated with a better one-year functional outcome. There was a higher risk of hip-related complications at four months in patients undergoing THA (P = 0.002). Conclusions: Despite more hip-related complications, THA can benefit patients with femoral neck fractures with higher four-month functional scores.
HEMIARTHROPLASTY VERSUS TOTAL HIP ARTHROPLASTY FOR THE TREATMENT OF FEMORAL NECK FRACTURES. A PROSPECTIVE COMPARATIVE STUDY / Orabona, Gianclaudio; Cerbasi, Simone; Costa, Giovangiuseppe; Recano, Pasquale; Misasi, Mario; Mariconda, Massimo. - In: HIP INTERNATIONAL. - ISSN 1120-7000. - 25:suppl. 1(2015), pp. 55-55. [10.5301/hipint.5000333]
HEMIARTHROPLASTY VERSUS TOTAL HIP ARTHROPLASTY FOR THE TREATMENT OF FEMORAL NECK FRACTURES. A PROSPECTIVE COMPARATIVE STUDY
ORABONA, GIANCLAUDIO;CERBASI, SIMONE;RECANO, PASQUALE;MARICONDA, MASSIMO
2015
Abstract
Introduction: The treatment of femoral neck fractures may affect the postoperative functional outcome in the elderly. Objectives: This comparative prospective study was carried out to evaluate the outcome of total hip arthroplasty (THA) versus hemiarthroplasty for femoral neck fractures. Methods: We selected 80 patients (17 males and 63 females) who underwent hemiarthroplasty (40 cases; mean age 74,0 ± 5.5 years) or THA (40 cases; mean age 71,4 ± 6.5 years) for a femoral neck fracture at our Institutions between January 2011 and April 2012. These two therapeutic groups were carefully matched for their preoperative characteristics including age, gender, body mass index, ASA class, comorbidities (CIRS score), cognitive function (MMSE). Four- and twelve-month mortality, walking ability, and activities of daily living (ADL Index) were prospectively assessed in the two groups. Hip-related and general complications also were specifically noted. Models of multiple regression analysis were constructed to evaluate the effect of the surgical treatment (hemiarthroplasty or THA) on functional outcomes and mortality. Results: The mortality at 4 and 12 months was not significantly different in the two therapeutic groups. The walking ability at 4 months (P<0.05) and the ADL score at 4 months (P<0.01) and one year (P = 0.01) was superior in patients with THA as compared to those who underwent hemiarthroplasty. The pre-fracture functional level (P<0.001) and the use of THA versus hemiarthroplasty (P = 0.01) represented strong predictors of the four-month ambulatory activity and ADL Index. The use of THA versus hemiarthroplasty was not associated with a better one-year functional outcome. There was a higher risk of hip-related complications at four months in patients undergoing THA (P = 0.002). Conclusions: Despite more hip-related complications, THA can benefit patients with femoral neck fractures with higher four-month functional scores.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
