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Hip, femur

The natural history of the hemiarthroplasty for displaced intracapsular femoral neck fractures

302 patients followed until revision or death

, , &
Pages 555-560 | Received 13 Jul 2013, Accepted 12 Oct 2013, Published online: 29 Nov 2013
 

Abstract

Background Numerous papers have been published on the medium- and long-term results of hemiarthroplasties (HAs) after femoral neck fracture in the elderly. We were not aware of any articles that describe the outcome of HA until the patient dies.

Methods Between 1975 and 1989, 307 bipolar hemiarthroplasties were performed in 302 consecutive patients with a displaced femoral neck facture. Patients with osteoarthritis of the hip, rheumatoid arthritis (RA), or senile dementia were not included in the study. All patients were followed annually until they died or until they needed a revision operation.

Results The mortality rate was 28% after 1 year, and 63% after 5 years. The last patient who did not need a revision operation died in October 2010. Revision operations for aseptic loosening, protrusion, or both had to be performed in 34 patients (16%). A difference in reoperation rate was observed between patients less than 75 years of age (38%) and those who were older (6%).

Interpretation Apart from age below 75 years, male sex appeared to be predictive of a revision operation. HA is a safe and relatively inexpensive treatment for patients over 75 years of age with a displaced femoral neck fracture.

All the authors contributed to interpretation of the data and to revision of the final manuscript. HB and ER contributed to the conception of the study and wrote the study protocol. ER and HB collected data. MB, IS, and ER analyzed the data. IS did the statistical analysis. MB wrote the first draft of the manuscript.

This study could not have been done without the continuous logistical support of the AO Documentation Center, Davos, Switzerland.

No competing interests declared.