Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly Has a Low Conversion Rate
Abstract Background Hemiarthroplasty (HA) has been a mainstay treatment for displaced femoral neck fractures for many years. The purpose of this study was to report the conversion rate of HA to total hip arthroplasty (THA) for displaced femoral neck fractures, and compare outcomes between implant co...
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| Veröffentlicht in: | The Journal of arthroplasty 2017-01, Vol.32 (1), p.150-154 |
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| creator | Grosso, Matthew J., MD Danoff, Jonathan R., MD Murtaugh, Taylor S., BS Trofa, David P., MD Sawires, Andrew N., BS Macaulay, William, MD |
| description | Abstract Background Hemiarthroplasty (HA) has been a mainstay treatment for displaced femoral neck fractures for many years. The purpose of this study was to report the conversion rate of HA to total hip arthroplasty (THA) for displaced femoral neck fractures, and compare outcomes between implant constructs (bipolar versus unipolar), fixation options (cemented v. cementless stems), and age groups ( |
| doi_str_mv | 10.1016/j.arth.2016.06.048 |
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The purpose of this study was to report the conversion rate of HA to total hip arthroplasty (THA) for displaced femoral neck fractures, and compare outcomes between implant constructs (bipolar versus unipolar), fixation options (cemented v. cementless stems), and age groups (<75 years versus ≥75 years). Methods We retrospectively reviewed the results of a consecutive cohort of 686 patients who underwent HA for the treatment of femoral neck fractures at our institution between 1999 and 2013 with a minimum of 2 years follow up. Results The overall component revision rate, including conversion to THA, revision HA, revision with ORIF, and Girdlestone procedure, was 5.6% (39/686). Seventeen patients (2.5%) were converted from HA to THA at an average of 1.9 years after index procedure. A significantly lower conversion rate of 1.4% (7/499 patients) was found in the older patient cohort (≥75 years old) compared to 5.3% (11/187) in the younger cohort. The most common causes for conversion surgery to THA were acetabular wear (5 patients), aseptic loosening (4 patients), and periprosthetic fracture (3 patients). There was a significantly lower rate of periprosthetic fracture (0.4% versus 2.5%, p-value 0.025) in the cemented implant group compared to the cementless group. We observed a higher rate of dislocations in the bipolar versus unipolar group (3.8% versus 1%, p-value 0.02), and no other significant differences between these groups. Conclusion We observed a low reoperation rate for this cohort of patients, relatively higher conversion rates for the younger population, fewer periprosthetic fractures with the use of cemented stems, and no advantage of bipolar over unipolar prostheses.</description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2016.06.048</identifier><identifier>PMID: 27480829</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acetabulum - surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip - statistics & numerical data ; bipolar ; Bone Cements ; cemented femoral stem ; cementless femoral stem ; Female ; femoral neck fracture ; Femoral Neck Fractures - surgery ; Fracture Fixation, Internal - methods ; hemiarthroplasty ; Hemiarthroplasty - statistics & numerical data ; Hip Prosthesis - adverse effects ; Hip Prosthesis - statistics & numerical data ; Humans ; Joint Dislocations - etiology ; Male ; Middle Aged ; Orthopedics ; Periprosthetic Fractures - surgery ; Prosthesis Design ; Reoperation - statistics & numerical data ; Retrospective Studies ; Treatment Outcome ; unipolar ; Young Adult</subject><ispartof>The Journal of arthroplasty, 2017-01, Vol.32 (1), p.150-154</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-79cdc5db7be1cf3fa8dda04fed9759e4e59584780448474a5f9c8db24063f9933</citedby><cites>FETCH-LOGICAL-c411t-79cdc5db7be1cf3fa8dda04fed9759e4e59584780448474a5f9c8db24063f9933</cites><orcidid>0000-0003-0394-3197 ; 0000-0002-6610-6022</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.arth.2016.06.048$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27480829$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grosso, Matthew J., MD</creatorcontrib><creatorcontrib>Danoff, Jonathan R., MD</creatorcontrib><creatorcontrib>Murtaugh, Taylor S., BS</creatorcontrib><creatorcontrib>Trofa, David P., MD</creatorcontrib><creatorcontrib>Sawires, Andrew N., BS</creatorcontrib><creatorcontrib>Macaulay, William, MD</creatorcontrib><title>Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly Has a Low Conversion Rate</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>Abstract Background Hemiarthroplasty (HA) has been a mainstay treatment for displaced femoral neck fractures for many years. The purpose of this study was to report the conversion rate of HA to total hip arthroplasty (THA) for displaced femoral neck fractures, and compare outcomes between implant constructs (bipolar versus unipolar), fixation options (cemented v. cementless stems), and age groups (<75 years versus ≥75 years). Methods We retrospectively reviewed the results of a consecutive cohort of 686 patients who underwent HA for the treatment of femoral neck fractures at our institution between 1999 and 2013 with a minimum of 2 years follow up. Results The overall component revision rate, including conversion to THA, revision HA, revision with ORIF, and Girdlestone procedure, was 5.6% (39/686). Seventeen patients (2.5%) were converted from HA to THA at an average of 1.9 years after index procedure. A significantly lower conversion rate of 1.4% (7/499 patients) was found in the older patient cohort (≥75 years old) compared to 5.3% (11/187) in the younger cohort. The most common causes for conversion surgery to THA were acetabular wear (5 patients), aseptic loosening (4 patients), and periprosthetic fracture (3 patients). There was a significantly lower rate of periprosthetic fracture (0.4% versus 2.5%, p-value 0.025) in the cemented implant group compared to the cementless group. We observed a higher rate of dislocations in the bipolar versus unipolar group (3.8% versus 1%, p-value 0.02), and no other significant differences between these groups. Conclusion We observed a low reoperation rate for this cohort of patients, relatively higher conversion rates for the younger population, fewer periprosthetic fractures with the use of cemented stems, and no advantage of bipolar over unipolar prostheses.</description><subject>Acetabulum - surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Hip - statistics & numerical data</subject><subject>bipolar</subject><subject>Bone Cements</subject><subject>cemented femoral stem</subject><subject>cementless femoral stem</subject><subject>Female</subject><subject>femoral neck fracture</subject><subject>Femoral Neck Fractures - surgery</subject><subject>Fracture Fixation, Internal - methods</subject><subject>hemiarthroplasty</subject><subject>Hemiarthroplasty - statistics & numerical data</subject><subject>Hip Prosthesis - adverse effects</subject><subject>Hip Prosthesis - statistics & numerical data</subject><subject>Humans</subject><subject>Joint Dislocations - etiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Periprosthetic Fractures - surgery</subject><subject>Prosthesis Design</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><subject>unipolar</subject><subject>Young Adult</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9rGzEQxUVpady0X6CHomMv6-jvrhZKoThxHTANpO21QpZmiRztypV2E_zto8VpDz0UBmYG3nswv0HoPSVLSmh9sV-aNN4tWZmXpJRQL9CCSs4qJUj9Ei2IUrySgvAz9CbnPSGUSileozPWCEUUaxfo1wZ6P8ekeAgmj0fcxYQvfS6bBYfX0MdkAv4G9h6vk7HjlCBjP-DxDvBVcJDCEW9MxgZv4yNexeEBUvZxwLdmhLfoVWdChnfP_Rz9XF_9WG2q7c3X69WXbWUFpWPVtNZZ6XbNDqjteGeUc4aIDlzbyBYEyFYq0SgiRGnCyK61yu1YOZN3bcv5Ofp4yj2k-HuCPOreZwshmAHilDVVrG54WytapOwktSnmnKDTh-R7k46aEj1z1Xs9A9EzV01KCVVMH57zp10P7q_lD8gi-HQSQLnywUPS2XoYCkKfwI7aRf___M__2G3wg7cm3MMR8j5OaSj8NNWZaaK_z5-dH0trTrhggj8BoGGeWQ</recordid><startdate>20170101</startdate><enddate>20170101</enddate><creator>Grosso, Matthew J., MD</creator><creator>Danoff, Jonathan R., MD</creator><creator>Murtaugh, Taylor S., BS</creator><creator>Trofa, David P., MD</creator><creator>Sawires, Andrew N., BS</creator><creator>Macaulay, William, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0394-3197</orcidid><orcidid>https://orcid.org/0000-0002-6610-6022</orcidid></search><sort><creationdate>20170101</creationdate><title>Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly Has a Low Conversion Rate</title><author>Grosso, Matthew J., MD ; Danoff, Jonathan R., MD ; Murtaugh, Taylor S., BS ; Trofa, David P., MD ; Sawires, Andrew N., BS ; Macaulay, William, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-79cdc5db7be1cf3fa8dda04fed9759e4e59584780448474a5f9c8db24063f9933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Acetabulum - surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Hip - statistics & numerical data</topic><topic>bipolar</topic><topic>Bone Cements</topic><topic>cemented femoral stem</topic><topic>cementless femoral stem</topic><topic>Female</topic><topic>femoral neck fracture</topic><topic>Femoral Neck Fractures - surgery</topic><topic>Fracture Fixation, Internal - methods</topic><topic>hemiarthroplasty</topic><topic>Hemiarthroplasty - statistics & numerical data</topic><topic>Hip Prosthesis - adverse effects</topic><topic>Hip Prosthesis - statistics & numerical data</topic><topic>Humans</topic><topic>Joint Dislocations - etiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Periprosthetic Fractures - surgery</topic><topic>Prosthesis Design</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><topic>unipolar</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grosso, Matthew J., MD</creatorcontrib><creatorcontrib>Danoff, Jonathan R., MD</creatorcontrib><creatorcontrib>Murtaugh, Taylor S., BS</creatorcontrib><creatorcontrib>Trofa, David P., MD</creatorcontrib><creatorcontrib>Sawires, Andrew N., BS</creatorcontrib><creatorcontrib>Macaulay, William, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grosso, Matthew J., MD</au><au>Danoff, Jonathan R., MD</au><au>Murtaugh, Taylor S., BS</au><au>Trofa, David P., MD</au><au>Sawires, Andrew N., BS</au><au>Macaulay, William, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly Has a Low Conversion Rate</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2017-01-01</date><risdate>2017</risdate><volume>32</volume><issue>1</issue><spage>150</spage><epage>154</epage><pages>150-154</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract>Abstract Background Hemiarthroplasty (HA) has been a mainstay treatment for displaced femoral neck fractures for many years. The purpose of this study was to report the conversion rate of HA to total hip arthroplasty (THA) for displaced femoral neck fractures, and compare outcomes between implant constructs (bipolar versus unipolar), fixation options (cemented v. cementless stems), and age groups (<75 years versus ≥75 years). Methods We retrospectively reviewed the results of a consecutive cohort of 686 patients who underwent HA for the treatment of femoral neck fractures at our institution between 1999 and 2013 with a minimum of 2 years follow up. Results The overall component revision rate, including conversion to THA, revision HA, revision with ORIF, and Girdlestone procedure, was 5.6% (39/686). Seventeen patients (2.5%) were converted from HA to THA at an average of 1.9 years after index procedure. A significantly lower conversion rate of 1.4% (7/499 patients) was found in the older patient cohort (≥75 years old) compared to 5.3% (11/187) in the younger cohort. The most common causes for conversion surgery to THA were acetabular wear (5 patients), aseptic loosening (4 patients), and periprosthetic fracture (3 patients). There was a significantly lower rate of periprosthetic fracture (0.4% versus 2.5%, p-value 0.025) in the cemented implant group compared to the cementless group. We observed a higher rate of dislocations in the bipolar versus unipolar group (3.8% versus 1%, p-value 0.02), and no other significant differences between these groups. Conclusion We observed a low reoperation rate for this cohort of patients, relatively higher conversion rates for the younger population, fewer periprosthetic fractures with the use of cemented stems, and no advantage of bipolar over unipolar prostheses.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27480829</pmid><doi>10.1016/j.arth.2016.06.048</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0003-0394-3197</orcidid><orcidid>https://orcid.org/0000-0002-6610-6022</orcidid></addata></record> |
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| subjects | Acetabulum - surgery Adolescent Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip - statistics & numerical data bipolar Bone Cements cemented femoral stem cementless femoral stem Female femoral neck fracture Femoral Neck Fractures - surgery Fracture Fixation, Internal - methods hemiarthroplasty Hemiarthroplasty - statistics & numerical data Hip Prosthesis - adverse effects Hip Prosthesis - statistics & numerical data Humans Joint Dislocations - etiology Male Middle Aged Orthopedics Periprosthetic Fractures - surgery Prosthesis Design Reoperation - statistics & numerical data Retrospective Studies Treatment Outcome unipolar Young Adult |
| title | Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly Has a Low Conversion Rate |
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