In-Hospital Outcomes after Hemiarthroplasty versus Total Hip Arthroplasty for Isolated Femoral Neck Fractures

  Background:    Previous studies suggest total hip arthroplasty may have some benefits compared to hemi-arthroplasty for displaced intracapsular femoral neck fractures in patients more than ۶۰ years of age. The primary research question of our study was whether in-hospital adverse events, post-operative length of stay (LOS) and mortality in patients ۶۰ year of age or older differed between total hip and hemi-arthroplasty for femoral neck fracture.    Methods:    We obtained data on ۸۲۹۵۱ patients more than ۶۰ years of age with an isolated femoral neck fracture treated with either hemi-arthroplasty or total hip arthroplasty in ۲۰۰۹ or ۲۰۱۰ from the National Hospital Discharge Survey (NHDS) database. The International Classification of Diseases, ۹th Revision, Clinical Modification (ICD-۹, CM) was used to code diagnoses, comorbidities, complications, and procedures.    Results:    Controlling for demographics and comorbidities, patients treated with hemi-arthroplasty had a ۴۰% (۹۵% CI ۱.۴-۱.۵) higher risk of adverse events compared to patients treated with a total hip arthroplasty. Length of stay and in-hospital mortality did not differ between these groups.  Conclusions:   The observed advantage for total hip arthroplasty might reflect greater infirmity in hemi-arthroplasty patients that was not accounted for by ICD-۹ codes alone.

Keywords:

complication , femoral neck fracture , Hemiarthroplasty , Inpatient , Length of stay , Mortality , Total hip arthroplasty