Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture

To the Editor: In a multicenter, randomized, controlled trial, the investigators who conducted the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemi-Arthroplasty (HEALTH) trial (Dec. 5 issue)¹ compared the results of total hip arthroplasty with hemiarthroplasty in elderly patients with displaced femoral neck fractures. The results should be interpreted with caution. First, patient outcomes were analyzed within 24 months after surgery. Considering that implant survivorship in hip arthroplasty generally starts to diverge 10 years after surgery, such a short-term follow-up does not allow for appreciation of the ultimate outcomes of the procedures.