Hemiarthroplasty or total hip arthroplasty for the treatment of a displaced intracapsular fracture in active elderly patients: 12-year follow-up of randomised trial.
OBJECTIVE
Our aim was to analyse the long-term functional outcome of two forms of surgical treatment for active patients aged > 70 years with a displaced intracapsular fracture of the femoral neck. Patients were randomised to be treated with either a hemiarthroplasty or a total hip arthroplasty (THA). The outcome five years post-operatively for this cohort has previously been reported. We present the outcome at 12 years post-operatively.


METHODS
Initially 252 patients with a mean age of 81.1 years (70.2 to 95.6) were included, of whom 205 (81%) were women. A total of 137 were treated with a cemented hemiarthroplasty and 115 with a cemented THA. At long-term follow-up we analysed the modified Harris Hip Score (HHS), post-operative complications and intra-operative data of the patients who were still alive.


RESULTS
At a mean follow-up of 12 years (8.23 to 16.17, standard deviation 2.24), 50 patients (20%), 32 in the hemiarthroplasty group and 18 in the THA group, were still alive, of which 47 (94%) were women. There were no significant differences in the mean modified HHS (p = 0.85), mortality (p = 0.13), complications (p = 0.93) or rate of revision surgery (p = 1.0) between the two groups.


CONCLUSIONS
In the treatment of active elderly patients with an intracapsular fracture of the hip there is no difference in the functional outcome between hemiarthroplasty and THA treatments at 12 years post-operatively. Cite this article: Bone Joint J 2017;99-B:250-4.
Academic Medical Center, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
M C J M
MC
Tol
Onze Lieve Vrouwe Gasthuis, P.O. 95500, 1090 HM Amsterdam, The Netherlands.
M P J
MP
van den Bekerom
Slotervaart Center, P.O. 90440, 1006 BK Amsterdam, The Netherlands.
I N
IN
Sierevelt
Academic Medical Center, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
E F
EF
Hilverdink
Academic Medical Center, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
E L F B
EL
Raaymakers
Academic Medical Center, P.O. Box 22660, 1105 AZ Amsterdam, The Netherlands.
J C
JC
Goslings
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D015444:Exercise; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D062785:Hemiarthroplasty; D006801:Humans; D057072:Intra-Articular Fractures / Q000601:surgery*; D017746:Joint Capsule / Q000293:injuries / Q000601:surgery*; D008297:Male; D020127:Recovery of Function; D016896:Treatment Outcome
Harris Hip Score; Hemiarthroplasty; Hip fractures; Total hip arthroplasty; Trauma