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Age matters when comparing hemiarthroplasty and total hip arthroplasty for femoral neck fractures in Medicare patients
- Source :
- HIP International. 29:674-679
- Publication Year :
- 2018
- Publisher :
- SAGE Publications, 2018.
-
Abstract
- Introduction: The optimal treatment of patients with a displaced intracapsular femoral neck fracture remains controversial. We utilised a national database of Medicare patients to determine if there was any difference in complications and reoperation rate of patients undergoing total hip arthroplasty (THA) or hemiarthroplasty (HA) for femoral neck fractures. Methods: This study utilised the PearlDiver Patient Records Database, a national for-fee database of Medicare patient procedure and diagnosis records from 2005 to 2012. Outcome procedures and diagnoses including revision, dislocation, infection, and cardiovascular events that occurred during the study time period were also identified over the entire study period as well as 90 days and 2 years. Results: We identified 275,439 patients with femoral neck fractures who underwent HA and 26,017 patients who underwent THA, respectively. Patients undergoing HA had significantly lower rates ( p < 0.0001) of revision 2.48% versus 3.85% (OR = 0.633; 95% CI, 0.592–0.678), dislocation 1.76% versus 3.39% (0.512; 0.476–0.551), infection 3.44% versus 4.87% (0.694; 0.657–0.737). There was no statistical significant difference in 2-year cardiac morbidity ( p = 0.252). However, when controlling for age, patients 65–69 years showed no significant difference in infection or revision over the study period or at 2 years. Conclusions: In this study, patients who underwent THA for femoral neck fractures had a higher rate of dislocations, infections and increased rates of repeat surgery than those who underwent HA but this difference was not significant in patients 65–69 years. Hemiarthroplasty may result in fewer complications in older Medicare patients although this difference may not be present in younger Medicare patients.
- Subjects :
- Male
Reoperation
medicine.medical_specialty
Arthroplasty, Replacement, Hip
medicine.medical_treatment
Medicare
Femoral Neck Fractures
03 medical and health sciences
Age Distribution
Postoperative Complications
0302 clinical medicine
medicine
Humans
Orthopedics and Sports Medicine
030212 general & internal medicine
Aged
Femoral neck
Aged, 80 and over
030222 orthopedics
business.industry
Incidence
Optimal treatment
Age Factors
Middle Aged
Arthroplasty
United States
Surgery
medicine.anatomical_structure
Female
National database
Hemiarthroplasty
business
Total hip arthroplasty
Subjects
Details
- ISSN :
- 17246067 and 11207000
- Volume :
- 29
- Database :
- OpenAIRE
- Journal :
- HIP International
- Accession number :
- edsair.doi.dedup.....196efad8eecf227b46cea9f63ca64ded