TY - JOUR
T1 - Acute femoral fracture does not compromise the outcome of total hip arthroplasty
T2 - 5 year results from a single center cohort study in 2,782 patients
AU - Bolder, Stefan B. T.
AU - Spaans, Elsa A.
AU - van den Hout, Joost A. A. M.
AU - Wagenmakers, Robert
AU - Koenraadt, Koen L. M.
N1 - Publisher Copyright: © 2021, Acta Orthopædica Belgica.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - National arthroplasty registries reveal a higher risk of revision for periprosthetic fracture and dislocation after total hip arthroplasty (THA) in patients with a femoral neck fracture compared to those with osteoarthritis (OA). Since these registries may contain confounding factors, we conducted a single center cohort study comparing survival and reason for failure between THA for an acute femoral neck fracture and OA using the same hip prosthesis after a minimum follow-up of 2 years. We retrospectively analyzed 2782 patients who had undergone THA with an Accolade TMZF stem and a Trident cup between March 2009 and September 2014. Primary diagnosis before THA was osteoarthritis (OA group: n=2610) or acute femoral fracture (Fracture group: n=172). Patients in both groups were operated on by the same hip surgeons. Effect of diagnosis on THA survival was analyzed using Cox-regression analysis. Chi-square tests were used to illustrate the different reasons for revision between the groups. Mean follow-up was 4.6 years (2-7.6). A total of 100 revisions were performed. The revision risk was comparable between the OA and Fracture group (HR=1.04, 95% CI:0.46-2.39). No differences were found between the OA and Fracture group with respect to the occurrence of periprosthetic fractures (0.8% vs. 0.6%, p=0.71) and revisions for dislocation (0.6% vs. 1.2%, p=0.38). We found no difference in outcome or reason for revision between THA for OA or femoral neck fracture. Using an implant with a proven ODEP rating and having experienced hip surgeons carry out the procedures may be more important than the primary diagnosis.
AB - National arthroplasty registries reveal a higher risk of revision for periprosthetic fracture and dislocation after total hip arthroplasty (THA) in patients with a femoral neck fracture compared to those with osteoarthritis (OA). Since these registries may contain confounding factors, we conducted a single center cohort study comparing survival and reason for failure between THA for an acute femoral neck fracture and OA using the same hip prosthesis after a minimum follow-up of 2 years. We retrospectively analyzed 2782 patients who had undergone THA with an Accolade TMZF stem and a Trident cup between March 2009 and September 2014. Primary diagnosis before THA was osteoarthritis (OA group: n=2610) or acute femoral fracture (Fracture group: n=172). Patients in both groups were operated on by the same hip surgeons. Effect of diagnosis on THA survival was analyzed using Cox-regression analysis. Chi-square tests were used to illustrate the different reasons for revision between the groups. Mean follow-up was 4.6 years (2-7.6). A total of 100 revisions were performed. The revision risk was comparable between the OA and Fracture group (HR=1.04, 95% CI:0.46-2.39). No differences were found between the OA and Fracture group with respect to the occurrence of periprosthetic fractures (0.8% vs. 0.6%, p=0.71) and revisions for dislocation (0.6% vs. 1.2%, p=0.38). We found no difference in outcome or reason for revision between THA for OA or femoral neck fracture. Using an implant with a proven ODEP rating and having experienced hip surgeons carry out the procedures may be more important than the primary diagnosis.
KW - Arthroplasty
KW - Femoral neck fracture
KW - Hip
KW - Osteoarthritis
UR - http://www.scopus.com/inward/record.url?scp=85115944242&partnerID=8YFLogxK
U2 - https://doi.org/10.52628/87.2.19
DO - https://doi.org/10.52628/87.2.19
M3 - Article
SN - 0001-6462
VL - 87
SP - 332
EP - 338
JO - Acta orthopaedica Belgica
JF - Acta orthopaedica Belgica
IS - 2
ER -