Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH): a multi-centre randomised trial comparing sliding hip screws and cancellous screws on revision surgery rates and quality of life in the treatment of femoral neck fractures

Background and Objective. Intracapsular fractures of the femoral neck account for a major share of fractures in the elderly. Open reduction and internal fixation has been shown to have a higher rate of revision surgery than arthroplasty. The aim of this study was to assess and compare the rates of revision surgery performed after internal fixation and primary total hip arthroplasty. Material and Methods. Between 2004 and 2006, 681 intracapsular femoral neck fractures in 679 consecutive patients were treated with internal fixation or total hip arthroplasty at our institution. Revision surgery rates were evaluated at 1-, 3-, 6-, 12-, and 24-month follow-up. Results. There was no significant difference in the ratio of internal fixation to total hip arthroplasty during 2004–2006 (P=0.31). The mean rate of total hip arthroplasty was 19.1% with a lower rate being among patients younger than 60 years. Revision surgery rates at the 2-year followup were higher in the internal fixation group compared with total hip arthroplasty group (28.9% vs. 7.0%, P<0.001). Patients who underwent internal fixation were at a 4-fold greater risk of having revision surgery at the 2-year follow-up than those who underwent total hip arthroplasty (odds ratio, 4.11; 95% CI, 1.95–8.65; P<0.001). Age was a significant risk factor for revision surgery after total hip arthroplasty (hazard ratio, 0.93; 95% CI, 0.87–0.98; P=0.02), but not significant after the internal fixation (P=0.86). Conclusions. Higher revision surgery rates after internal fixation favors arthroplasty as a primary choice of treatment for the femoral neck fractures.

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Quality of Life Related to Fracture Displacement Among Elderly Patients With Femoral Neck Fractures Treated With Internal Fixation

Journal of Orthopaedic Trauma ◽

10.1097/00005131-200309001-00005 ◽

2003 ◽

Vol 17 (SUPPLEMENT) ◽

pp. S17-S21 ◽

Cited By ~ 12

Author(s):

Jan Tidermark ◽

Niklas Zethraeus ◽

Olle Svensson ◽

Hans Törnkvist ◽

Sari Ponzer

Keyword(s):

Quality Of Life ◽

Femoral Neck ◽

Elderly Patients ◽

Internal Fixation ◽

Femoral Neck Fractures ◽

Fracture Displacement

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Comparing total hip arthroplasty and hemi-arthroplasty on revision surgery and quality of life in adults with displaced hip fractures: the HEALTH study

http://isrctn.org/> ◽

10.1186/isrctn59890378 ◽

2013 ◽

Author(s):

Mohit Bhandari

Keyword(s):

Quality Of Life ◽

Total Hip Arthroplasty ◽

Hip Fractures ◽

Hip Arthroplasty ◽

Revision Surgery ◽

Health Study ◽

Total Hip ◽

Hemi Arthroplasty

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Recovery after Hip Fractures: Influence of Bipolar Hemiarthroplasty on Physical Disability and Social Dependency in the Elderly

Hip International ◽

10.5301/hip.2011.8824 ◽

2011 ◽

Vol 21 (6) ◽

pp. 751-756 ◽

Cited By ~ 6

Author(s):

Johannes Schneppendahl ◽

Marcel Betsch ◽

Vanco Petrov ◽

Friedrich Böttner ◽

Simon Thelen ◽

...

Keyword(s):

Quality Of Life ◽

Femoral Neck ◽

Femoral Neck Fracture ◽

Geriatric Patients ◽

Femoral Neck Fractures ◽

Bipolar Hemiarthroplasty ◽

Displaced Femoral Neck Fractures ◽

Neck Fracture ◽

Original Type

Surgical treatment of femoral neck fractures is associated with a significant impact on quality of life. The aim of this study was to determine the long-term influence of displaced femoral neck fractures treated by bipolar hemiarthroplasty on the activities of daily living, quality of life and social dependency. We studied 487 geriatric patients treated in the years 1989 to 2003. At the beginning of follow-up in 2004, 166 patients were alive and evaluation was carried out on 145 patients (87.3%) at 91.3 (14 - 244) months postoperatively by a standardized questionnaire. All enrolled patients had been treated with cemented bipolar hemiarthroplasty for a displaced femoral neck fracture. Patients were evaluated concerning their average pre- and postoperative ability to walk, the need for assisting devices, type of residency and the SF-12® Score. Femoral neck fracture and hemiarthroplasty had a significant influence on all recorded aspects of quality of life. Even though almost two thirds of the patients needed assisting devices to walk after surgery, about two thirds returned to their original type of accommodation and the majority reached their original degree of mobility. Compared to a normal population no significant impact was observed on the quality of life measured by the SF-12® score. We consider bipolar hemiarthroplasty an effective treatment option for displaced femoral neck fractures in geriatric patients. Most patients returned to their original type of accommodation and level of mobility, even though the majority required a number of assisting devices to do so.

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