Document Detail


A comparison of hemiarthroplasty with total hip replacement for displaced intracapsular fracture of the femoral neck: a randomised controlled multicentre trial in patients aged 70 years and over.
MedLine Citation:
PMID:  20884982     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to analyse the functional outcome after a displaced intracapsular fracture of the femoral neck in active patients aged over 70 years without osteoarthritis or rheumatoid arthritis of the hip, randomised to receive either a hemiarthroplasty or a total hip replacement (THR). We studied 252 patients of whom 47 (19%) were men, with a mean age of 81.1 years (70.2 to 95.6). They were randomly allocated to be treated with either a cemented hemiarthroplasty (137 patients) or cemented THR (115 patients). At one- and five-year follow-up no differences were observed in the modified Harris hip score, revision rate of the prosthesis, local and general complications, or mortality. The intra-operative blood loss was lower in the hemiarthroplasty group (7% > 500 ml), THR group (26% > 500 ml) and the duration of surgery was longer in the THR group (28% > 1.5 hours versus 12% > 1.5 hours). There were no dislocations of any bipolar hemiarthroplasty than in the eight dislocations of a THR during follow-up. Because of a higher intra-operative blood loss (p < 0.001), an increased duration of the operation (p < 0.001) and a higher number of early and late dislocations (p = 0.002), we do not recommend THR as the treatment of choice in patients aged ≥ 70 years with a fracture of the femoral neck in the absence of advanced radiological osteoarthritis or rheumatoid arthritis of the hip.
Authors:
M P J van den Bekerom; E F Hilverdink; I N Sierevelt; E M B P Reuling; J M Schnater; H Bonke; J C Goslings; C N van Dijk; E L F B Raaymakers
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of bone and joint surgery. British volume     Volume:  92     ISSN:  0301-620X     ISO Abbreviation:  J Bone Joint Surg Br     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-11-29     Revised Date:  2011-01-18    
Medline Journal Info:
Nlm Unique ID:  0375355     Medline TA:  J Bone Joint Surg Br     Country:  England    
Other Details:
Languages:  eng     Pagination:  1422-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip / adverse effects,  methods*
Blood Loss, Surgical
Female
Femoral Neck Fractures / surgery*
Follow-Up Studies
Humans
Intraoperative Period
Male
Reoperation
Treatment Outcome
Comments/Corrections
Erratum In:
J Bone Joint Surg Br. 2011 Jan;93(1):140

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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