Whether Hemiarthroplasty Remains a Gold Standard Treatment for Patients With Displaced Femoral Neck Fractures? - A 20-year Sample of 4516 Patients From a Single Institute

Abstract BackgroundFemoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. This study analysed the causes of HA failure and reevaluated whether HA remains a gold standard treatment for patients with displaced FNFs.MethodsA total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients were enrolled who received the diagnosis of a displaced FNF, underwent primary HA initially, required second revision procedures, and were followed up for a minimum of 36 months. Data were collected and comprehensively analysed.ResultsIn 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months.ConclusionHA has an extremely low revision rate and remains a gold standard treatment for patients with displaced FNFs.Levels of Evidence: Level III, Retrospective Cohort Study, Therapeutic Study