J Int Med Res. 2018 Jul; 46(7): 2717–2730.

Comparison of hemiarthroplasty and total hip arthroplasty in elderly patients with displaced femoral neck fractures

Fatih Canşah Barışhan, Burak Akesen, Teoman Atıcı, Kemal Durak, and Muhammed Sadık Bilgen
Hip

Objective

This study was performed to compare the clinical and radiological outcomes of displaced femoral neck fractures (FNFs) treated with either hemiarthroplasty or total hip arthroplasty (THA) in elderly patients. Morbidity and mortality were also evaluated.

Methods

Twenty-two patients who underwent hemiarthroplasty and 16 patients who underwent THA for treatment of Garden type 3–4 FNFs from 2012 to 2015 were enrolled in this study. All patients were >65 years of age. Cox regression analysis was performed for mortality evaluation.

Results

The postoperative blood loss volume, decrease in the hemoglobin level, and transfusion rate were significantly higher in the THA group. The univariate mortality risk was higher in patients with a Charlson comorbidity score of >4, American Society of Anesthesiologists score of >2, Singh index of <3, and postoperative hospitalization of >1 week.

Conclusion

This study revealed no significant difference in the short-term clinical and radiological results between cementless hemiarthroplasty and THA in elderly patients with displaced FNFs. However, morbidity and mortality were associated with the presence of additional systemic diseases. THA is the preferred surgical technique in patients with displaced FNFs and low comorbidities.


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