Low rates of all-cause revision in displaced subcapital femoral neck fractures treated with hip hemiarthroplasty - a ret

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(2020) 21:700

RESEARCH ARTICLE

Open Access

Low rates of all-cause revision in displaced subcapital femoral neck fractures treated with hip hemiarthroplasty - a retrospective review of 4516 patients from a single institute Chi-Yung Yeung1,2, Shang-Wen Tsai1,2, Po-Kuei Wu1,2, Cheng-Fong Chen1,2* , Ming-Chau Chang1,2 and Wei-Ming Chen1,2

Abstract Background: Femoral neck fracture (FNF) is among the commonest fractures affecting the geriatric population. Hemiarthroplasty (HA) is a standard treatment procedure and has been performed by hip surgeons for decades. Recently, primary total hip replacement has proved advantageous for the treatment of such fractures. The aim of this study is to retrospectively review all causes of failure of all patients who underwent HA in our institute and reevaluated whether HA remains a favourable choice of treatment for patients with displaced FNFs. Methods: A total of 4516 patients underwent HA at our centre from 1998 to 2017. The HA implants included unipolar and bipolar prostheses. Patients diagnosed with displaced FNF, underwent primary HA initially, required second revision procedures, and followed up for a minimum of 36 months were included in this study. Data were collected and comprehensively analysed. Results: In 4516 cases, 99 patients underwent second surgeries. The revision rate was 2.19%. Reasons for failure were acetabular wear (n = 30, 30.3%), femoral stem subsidence (n = 24, 24.2%), periprosthetic fracture (n = 22, 22.2%), infection (n = 16, 16.2%), and recurrent dislocation (n = 7, 7.1%). The mean follow-up period was 78.1 months. The interval between failed HA and revision surgery was 22.8 months. Conclusion: HA has a low revision rate and remains a favourable choice of treatment for patients with displaced FNFs. Levels of evidence: Level III, Retrospective Cohort Study, Therapeutic Study. Keywords: Femoral neck fractures, Austin Moore hemiarthroplasty, Bipolar hemiarthroplasty, Hemiarthroplasty failure, Conversion total hip replacement

* Correspondence: [email protected] 1 Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei 112, Taiwan, Republic of China 2 Department of Orthopaedics, School of Medicine, National Yang-Ming University, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City 11217, Taiwan, Republic of China © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation