Effects of delayed hip replacement on postoperative hip function and quality of life in elderly patients with femoral neck fracture

Abstract

Background: For various reasons, some elderly patients with femoral neck fracture undergo delayed surgical treatment. There is little information about the effect of delayed treatment on postoperative hip function and quality of life. The aim of this study was to investigate the effect of delayed hip arthroplasty on hip function, quality of life, and satisfaction in patients with femoral neck fractures. Methods: Forty-seven patients with femoral neck fracture and hip replacement delayed over 21 days served as the delayed group (D group). Patients with femoral neck fracture, matched 1:1 for age and sex, and hip replacement within 7 days served as the control group (C group). The Harris hip score (HHS) and health-related quality of life (HRQoL) were assessed before surgery and 3 months, 6 months and 1 year postoperatively. The satisfaction questionnaires were completed by the patients themselves at the last follow-up. Results: The HHS in the C group was lower than that in the D group (32.64 ± 9.11 vs. 46.32 ± 9.88, P < 0.05) before surgery but recovered faster after surgery. The HHS in the D group was lower than that in the C group 1 year postoperatively (85.2 ± 3.80 vs. 89.8 ± 3.33, P < 0.05). The patients' quality of life changed similarly to their HHS. The HHS 1 year after surgery was related to the preoperative HHS in group D (r s = 0.521, P < 0.01). Patients in the D group showed significantly higher satisfaction scores than those in the C group (P < 0.05). Conclusions: Hip function in patients with femoral neck fracture surgery delayed over 21 days recovered more slowly than that in those who underwent surgery within 7 days. However, they were more satisfied with the surgery. Moderate hip movement to ameliorate the lower limb muscle atrophy was recommended for patients facing a temporary inability to undergo surgery.

Prognostic Factors for Mortality, Activity of Daily Living, and Quality of Life in Taiwanese Older Patients within 1 Year Following Hip Fracture Surgery

“…Mortality significantly increased for patients receiving hip repair surgery >24 hours after admission compared with those operated on within 24 hours [11]. A surgical delay of >21 days had a significantly poorer hip function and QoL than an operation within 7 days of the fracture [12]. Moreover, delays in surgery are correlated with a longer length of hospitalization and a lower possibility of returning to independent living [13].…”

Effect of Early Mobilization on Hip and Lower Extremity Postoperative: A Literature Review

“…This high morbidity and mortality rate is associated with some complications due to prolonged bed rest after surgery ( Kenyon-Smith et al, 2019 ). Complications may include heart failure, thromboembolism, pneumonia, pressure ulcers, wound healing disorders, and delirium ( Flikweert et al, 2018 ; Song et al, 2020 ). Another complication Biz et al (2020) reported was the failure of femoral fracture osteosynthesis.…”

Does early surgery prevent Postoperative ICU admission after surgery for the fracture of the hip. Nested case control study of 911 patients

“…Current guidelines, however, recommend early surgery, if possible, because several studies have demonstrated improved outcomes, with no documented adverse effect of operating within 48 h, especially in otherwise physiologically healthy patients [ [10] , [11] , [12] , [13] , [14] ]. On the contrary, several deleterious effects have been reported with delayed surgery including, but not limited to, prolonged length of stay [ [15] , [16] , [17] ], pressure ulcers [ 6 , 10 ], arrhythmias [ 16 ], poor postoperative hip function [ 18 ] and increased mortality [ 12 , 19 ]. However, it is equally important to note that impetuous surgery without proper pre-operative stabilization can also lead to adverse outcomes as most of these patients are elderly with multiple comorbidities [ 9 ].…”