Ron Ben Elyahu*, Basel Khateeb, Eyal Yaakobi, Ezequiel Palmanovich, Omer Marom, David Segal, Nissim Ohana, Michael Markushevich and Yaron S Brin
Department of Orthopedics, Meir Medical Center, IsraelFulltext PDF
Background: Displaced femoral neck fractures were treated historically with Hemi-Arthroplasty (HA), but the use of Total Hip Arthroplasty (THA) is increasing, with superior long-term results. Objectives: This study assessed whether THA has superior short-term results when compared to bipolar HA for displaced femoral neck fractures. Methods: We assessed two groups of active older patients who underwent cementless bipolar HA or THA for displaced femoral neck fracture. All patients were operated using the direct lateral approach to the hip joint. Patients were assessed using the Harris Hip Score at hospital discharge, and at 6 weeks follow-up. Results: Forty patients, ages 65 to 85 were included. Eighteen underwent bipolar HA and 22 THA. The number of women in each group was similar, as was mean age: 73.1 ± 4.2 years in the HA group and 71.0 ± 3.7 in THA. Harris Hip Score before hospital discharge was similar in both groups. Walking ability at discharge was better in the THA cohort and they were discharged sooner: 5.2 ± 1.3 vs. 6.4 ± 1.7 days following HA (p=0.021). At 6 weeks follow-up, the mean Harris Hip Score was higher in the THA group (78.6 ± 11 vs. 61.5 ± 17 for HA; p<0.001). Patients in the THA group walked longer distances, needed less support while walking, and reported less pain. Conclusion: We found better short-term results at hospital discharge and at 6 weeks follow-up after THA, which contribute to earlier patient independence and shorter hospital stays. Therefore, we recommend treating active older patients who sustain a displaced femoral neck fracture with THA.
Bipolar hemiarthroplasty; Femoral neck fracture; Hospital stay; Short-term clinical results; Total hip arthroplasty
Elyahu RB, Khateeb B, Yaakobi E, Palmanovich E, Marom O, Segal D, et al. Better Short-Term Outcomes after Total Hip Arthroplasty Compared to Hemiarthroplasty in Active Older Patients with Displaced Intracapsular Femoral Neck Fracture. World J Surg Surgical Res. 2021; 4: 1339..