Comparison of functional outcome of bipolar hip arthroplasty and total hip replacement in displaced femoral neck fractures in elderly in a developing country: a 2-year prospective study

Sonaje, Jayesh Chandrakant; Meena, Pradeep; Bansiwal, Ramesh Chandra; Bobade, Sandesh

doi:10.1007/s00590-017-2057-y

Cited by 28 publications

(24 citation statements)

References 28 publications

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“…Hip fractures place a large burden on our health-care system. 3,4,6 There is substantial controversy regarding the indications for THA and HHA as well as what should be the preferred treatment in different circumstances, 3,7,12,13 including in different age subgroups. Our study found that patients aged 65 years and older who were treated with a THA had decreased mortality when compared with propensity score–matched patients after HHA.…”

Section: Discussionmentioning

confidence: 99%

“…Displaced femoral neck hip fractures are currently treated with either total hip arthroplasty (THA) or hip hemiarthroplasty (HHA); however, treatment selection is controversial. 7-12 Guidelines in the United Kingdom recommend THA for patients who can ambulate outside the home, have no cognitive impairment, and are medically fit for the procedure. 13 Formal guidelines in other countries, such as the United States, are yet to be formulated.…”

Section: Introductionmentioning

confidence: 99%

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Total Hip Arthroplasty Outperforms Hemiarthroplasty in Patients Aged 65 Years and Older: A Propensity-Matched Study of Short-Term Outcomes

Warren

Sundaram

Anis

et al. 2019

Geriatr Orthop Surg Rehabil

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Introduction: Displaced femoral neck fractures in the elderly individuals may be treated with total hip arthroplasty (THA) or hip hemiarthroplasty (HHA). However, it is unclear what the short-term medical outcomes are related to these surgical options. The purpose of this study was to compare early postoperative outcomes in THA patients to those of HHA patients. Methods: In this study, we compared 30-day mortality, likelihood of still being in the hospital at 30 days, postoperative major and minor complications, discharge disposition, reoperation and readmission, length of stay, days from admission to surgery, and operative time between THA and HHA. Using the American College of Surgeons National Surgical Quality Improvement Project database, hip fracture patients ≥65 years old from 2008 to 2016 were identified. After propensity score matching, there were 2795 THAs and 2795 HHAs. To assess the effect of THA on the above-mentioned outcomes, bivariate regression models were created. Results: The THA patients ≥65 years old were at reduced risk for mortality ( P = .029) and still being in the hospital at 30 days ( P = .017). The THA patients were at an increased risk for minor complications ( P = .011) and longer operative times ( P < .001). However, THA patients were more likely to have a home discharge ( P < .001). Discussion: Patients ≥65 years who underwent THA for hip fractures had reduced short-term mortality risk, were more likely to be discharged home, and had less likelihood of being in the hospital at 30 days. This is the first study to explore short-term outcomes in patients ≥65 and has direct implications for alternate payment and merit-based payment models. Conclusion: As hip fracture treatment has come under scrutiny with respect to alternate payment models and merit-based incentive payments, this analysis of short-term outcomes warrants consideration when evaluating treatment pathways.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Total Hip Arthroplasty Outperforms Hemiarthroplasty in Patients Aged 65 Years and Older: A Propensity-Matched Study of Short-Term Outcomes

Warren

Sundaram

Anis

et al. 2019

Geriatr Orthop Surg Rehabil

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“…It was reported that the levels of various cytokines, such as interleukin-6 are elevated [27]. Additionally, patients with CKD have higher levels of D-dimer, CRP, fibrinogen, factor VII, and factor VIII [28,29] Conclusions Downloaded from http://meridian.allenpress.com/japma/article-pdf/doi/10.7547/20-007/2557520/20-007.pdf by guest on 04 November 2020 JAPMA Online Early DOI: 10.7547/20-007 This Original Article has been reviewed, accepted for publication, and approved by the author. It has not been copyedited, proofread, or typeset and is not a final version.…”

Section: The Clinical Outcomes Of Total Hip Arthroplasty In Renal Tramentioning

confidence: 99%

Can Total Joint Arthroplasty Be Safely Performed in Patients with Chronic Kidney Disease?

Fan¹,

Sun²,

Jaing³

2021

Journal of the American Podiatric Medical Association

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BACKGROUND: Patients suffered from chronic kidneydisease are at greater risk of perioperative and postoperative complications. Actually there is no systerm review study demonstrating advantages of total joint arthroplasty can be safely performed in patients with chronic kidney disease.METHODS: Literature search was performed inPubMed, Embase, Web of Science, China National Knowledge Infrastructure(CNKI),Wanfang and Cochrane Library for information from the earliest date of data collection to September 2018. Studies comparing the perioperative, postoperative outcomes of No-CKD with those of CKD patients were included. Statistical heterogeneity was quantitatively evaluated by X2 test with the significance set P<0.10 or I2 > 50%.RESULTS:Three papers consisting of 38,209 patients were included (35,363 No-CKD patients; 2,846 CKD patients). The results showed that CKD was related to a greater increase in postoperative infection rate, deep vein thrombosis, re-admission and mortality(P<0.1). No differences inlength of surgery, length of stay, pulmonary embolism and revision (P>0.10).CONCLUSIONS:Compared with No-CKD patients, CKD patients demonstrated an increased risk of perioperative and postoperative complications and clear difference about complications between No-CKD and CKD about patients with chronic kidneydisease.

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“…During study selection, we excluded some RCTs, including five studies that incorporated patients younger than 75 years old [7,[34][35][36][37] and two studies included patients unable to live independently [38,39], and two studies included patients unable to live independently [40,41]. There were a total of 631 participants in the nine trials included in the study.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…THA and HA are widely used in the displaced femoral neck fractures (DFNF) [5]. HA has advantages of shorter operation times, less blood loss, less technical demand, less economic burden, and a lower post-operative dislocation rate [7][8][9][10]. THA procedures are associated with better hip function, less acetabulum erosion, and a lower revision rate, but more substantial surgical strike and a higher post-operative dislocation rate [7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Comparing total hip arthroplasty and hemiarthroplasty for the treatment of displaced femoral neck fracture in the active elderly over 75 years old: a systematic review and meta-analysis of randomised control trials

Liu

Chen

Zhang³

et al. 2019

Preprint

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Background: Displaced femoral neck fractures (DFNF) are increasingly common in elderly patients. Repair of DFNF can be completed using two methods, hemiarthroplasty (HA) or total hip Arthroplasty (THA). However, there is much controversy regarding whether HA or THA is superior in active elderly patients over 75 years old. Methods: We conducted the literature search by searching PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, and Web of Science from the inception dates to June 1, 2019. Randomised controlled trials (RCT) were included according to the inclusion and exclusion criteria. Included studies were analysed according to Cochrane review methods. Results: Nine studies met the inclusion criteria totalling 631 participants (301 THA and 330 HA）. Four of the studies conducted were identical to a previous study but look at different follow up measures. The analysis of previously collected data revealed that the THA group had a lower erosion rate, higher total pain and function HHS, and higher EQ-5Dindex. The re-operation rate was significantly lower in the THA group after five years of follow up after adding the patients with painful symptoms to the group of patients revised. However, THA had longer operative time and a higher dislocation rate in the first three years compared to the HA procedure. Moreover, there was an insignificant difference in mortality rate, general complications, wound infection, duration of hospital stay, and VTE prevalence among the two procedures. Conclusions: THA may be a preferred management option for active elderly patients over 75 years old, after careful evaluation of patients’ general condition and tolerance of surgery. Strict management and follow up protocols should be followed to prevent dislocation within the first three years following a THA. Trial registration: This study was registered at the International Prospective Register of Systematic Reviews (CRD42019139135). The date of registration is 16-06-2019. Keywords: displaced femoral neck fractures; total hip arthroplasty; hemiarthroplasty;

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Comparison of functional outcome of bipolar hip arthroplasty and total hip replacement in displaced femoral neck fractures in elderly in a developing country: a 2-year prospective study

Abstract: Level II, lesser-quality randomized controlled trial.

Cited by 28 publications

References 28 publications

Total Hip Arthroplasty Outperforms Hemiarthroplasty in Patients Aged 65 Years and Older: A Propensity-Matched Study of Short-Term Outcomes

Total Hip Arthroplasty Outperforms Hemiarthroplasty in Patients Aged 65 Years and Older: A Propensity-Matched Study of Short-Term Outcomes

Can Total Joint Arthroplasty Be Safely Performed in Patients with Chronic Kidney Disease?

Comparing total hip arthroplasty and hemiarthroplasty for the treatment of displaced femoral neck fracture in the active elderly over 75 years old: a systematic review and meta-analysis of randomised control trials

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