Hemiarthroplasty or total hip arthroplasty for the treatment of a displaced intracapsular fracture in active elderly patients: 12-year follow-up of randomised trial
2017
Aims Our aim was to analyse the long-term functional outcome of two
forms of surgical treatment for active patients aged > 70 years
with a displaced intracapsular fracture of the femoral neck. Patients
were randomised to be treated with either a hemiarthroplasty or
a total hip arthroplasty (THA). The outcome five years post-operatively
for this cohort has previously been reported. We present the outcome
at 12 years post-operatively. Patients and Methods Initially 252 patients with a mean age of 81.1 years (70.2 to
95.6) were included, of whom 205 (81%) were women. A total of 137
were treated with a cemented hemiarthroplasty and 115 with a cemented
THA. At long-term follow-up we analysed the modified Harris Hip
Score (HHS), post-operative complications and intra-operative data
of the patients who were still alive. Results At a mean follow-up of 12 years (8.23 to 16.17, standard deviation
2.24), 50 patients (20%), 32 in the hemiarthroplasty group and 18
in the THA group, were still alive, of which 47 (94%) were women.
There were no significant differences in the mean modified HHS (p
= 0.85), mortality (p = 0.13), complications (p = 0.93) or rate
of revision surgery (p = 1.0) between the two groups. Conclusion In the treatment of active elderly patients with an intracapsular
fracture of the hip there is no difference in the functional outcome
between hemiarthroplasty and THA treatments at 12 years post-operatively. Cite this article: Bone Joint J 2017;99-B:250–4.
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