title: The natural history of the hemiarthroplasty for displaced intracapsular femoral neck fractures.
abstract: BACKGROUND
  Numerous papers have been published on the medium- and long-term results of hemiarthroplasties (HAs) after femoral neck fracture in the elderly. We were not aware of any articles that describe the outcome of HA until the patient dies.
  
  
  METHODS
  Between 1975 and 1989, 307 bipolar hemiarthroplasties were performed in 302 consecutive patients with a displaced femoral neck facture. Patients with osteoarthritis of the hip, rheumatoid arthritis (RA), or senile dementia were not included in the study. All patients were followed annually until they died or until they needed a revision operation.
  
  
  RESULTS
  The mortality rate was 28% after 1 year, and 63% after 5 years. The last patient who did not need a revision operation died in October 2010. Revision operations for aseptic loosening, protrusion, or both had to be performed in 34 patients (16%). A difference in reoperation rate was observed between patients less than 75 years of age (38%) and those who were older (6%).
  
  
  CONCLUSIONS
  Apart from age below 75 years, male sex appeared to be predictive of a revision operation. HA is a safe and relatively inexpensive treatment for patients over 75 years of age with a displaced femoral neck fracture.
authors.affiliation: Department of Orthopaedic Surgery of the Onze Lieve Vrouwe Gasthuis , Amsterdam , the Netherlands.
authors.forename: Michel P J
authors.initials: MP
authors.lastname: van den Bekerom
authors.forename: Inger N
authors.initials: IN
authors.lastname: Sierevelt
authors.forename: Harmjan
authors.initials: H
authors.lastname: Bonke
authors.forename: Ernst L F B
authors.initials: EL
authors.lastname: Raaymakers
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D015897:Comorbidity; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D062785:Hemiarthroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure / Q000209:etiology; D012086:Reoperation / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D016896:Treatment Outcome