High failure rate after internal fixation and beneficial outcome after arthroplasty in treatment of displaced femoral neck fractures in patients between 55 and 70 years

Figures & data

Figure 1. Flow chart of patients included in the study.

Table 1. Baseline characteristics according to different operation types

Operation type	IF	HA	THA	p-value
Total number	1,111	1,030	572
Mean age (SD)	62.4 (4.2)	64.9 (3.6)	63.7 (3.9)	< 0.001^a
Female sex (%)	666 (60)	672 (65)	412 (72)	< 0.001^b
ASA classification (%)				< 0.001^b
ASA 1–2	782 (70)	467 (45)	419 (73)
ASA 3	290 (26)	505 (49)	147 (26)
ASA 4–5	39 (3.5)	58 (5.6)	6 (1.0)
Cognitive impairment (%)	41 (3.7)	99 (9.6)		< 0.001^b

a ANOVA.

b Pearson chi-square test.

Table 3. Numbers and types of major reoperations

Operation type	IF	HA	THA
Total number	1,111	1,030	572
Total reoperations	305	39	16
THA	229	11	11^a
HA	56	4
Girdlestone	4	3	5
Reosteosynthesis	16
Exchange of bipolar head^b		21

a Exchange of components: whole prosthesis (2), acetabulum (5), caput (3), femoral stem (1).

b Debridement for infection (17), dislocated prosthesis (4).

Figure 2. Adjusted survival of implants for the different treatment groups with major reoperations as endpoint, distributed by primary treatment method. Cox regression analyses with adjustments for age, sex, and ASA classification.

Table 6. PROM results for responders

	IF	HA		THA
	(n = 259)	(n = 148)	p-value^a	(n = 142)	p-value^b
Mean (SD) patient satisfaction (VAS)
At 4 months	35 (25)	24 (22)	< 0.001	20 (19)	< 0.001
At 12 months	32 (24)	28 (25)	0.2	23 (24)	< 0.001
Mean (SD) pain (VAS)
At 4 months	33 (23)	24 (20)	< 0.001	19 (20)	< 0.001
At 12 months	28 (23)	24 (22)	0.09	20 (22)	0.002
Mean (SD) EQ-5D index score
At 4 months	0.60 (0.24)	0,64 (0.24)	0.1	0.71 (0.23)	< 0.001
At 12 months	0.69 (0.24)	0.68 (0.27)	0.9	0.74 (0.24)	0.03
Mean (SD) EQ-VAS
At 4 months	67 (22)	68 (23)	0.6	73 (20)	0.01
At 12 months	73 (23)	69 (23)	0.2	73 (22)	0.9

a Student’s t-test (IF versus HA)

b Student’s t-test (IF versus THA)

Figure 3. Time trend for type of surgery.