The cost of hemiarthroplasty compared to that of internal fixation for femoral neck fractures

Frihagen, Frede; Waaler, Georg H. M.; Madsen, Jan Erik; Nordsletten, Lars; Aspaas, Silje; Aas, Eline

doi:10.3109/17453674.2010.492763

Cited by 40 publications

(43 citation statements)

References 14 publications

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“…This may indicate that the hip fracture care pathways as implemented in the Netherlands promoting early mobilization, early hospital discharge, and rehabilitation in a specialized nursing home department or at home lead to limited costs. The costs in our study are even >50% lower than published costs in 2010 and 2012 for Norway (Table 1) [7][8][9][10][11][12][13]. Differences can be explained by several factors.…”

Section: Discussioncontrasting

confidence: 40%

“…Patients were excluded if they (1) had a fracture not suitable for internal fixation (e.g,. pathological fracture, rheumatoid arthritis, or osteoarthritis), (2) had associated major injuries of the lower extremities, (3) had retained hardware around the hip, (4) had an infection around the hip, (5) had a bone metabolism disorder other than osteoporosis, (6) were moderately or severely cognitively impaired prefracture, (7) had dementia or Parkinson's disease severe enough to compromise the rehabilitation process, or (8) were not likely to be able to complete follow-up.…”

Section: Populationmentioning

confidence: 99%

“…This was a crude estimate of costs based on national databases and registrations, concerning costs of hip fracture patients, treated with various implants and prostheses. A number of studies compared the costs of treatment with internal fixation with costs of treatment with arthroplasty [7][8][9][10][11][12][13]. These studies demonstrated either similar or higher costs for patients treated with internal fixation, ranging from €13,000 to €57,197 per patient after a two-year follow-up period (Table 1).…”

Section: Introductionmentioning

confidence: 99%

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The societal costs of femoral neck fracture patients treated with internal fixation

Zielinski

Bouwmans²,

Heetveld

et al. 2013

Osteoporos Int

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Mini abstractThe study rationale was to provide a detailed overview of the costs for femoral neck fracture treatment with internal fixation in the Netherlands. Mean total costs per patient at two years follow-up were €19,425. Costs were higher for older, less healthy patients. Results are comparable to internationally published costs.3 Abstract Purpose: The aim of this study was to provide a detailed overview of the cost and healthcare consumption of patients treated for a hip fracture with internal fixation. A secondary aim was to compare costs of patients who underwent a revision surgery with patients who did not. Methods:The study was performed alongside the Dutch sample of an international randomized controlled trial, concerning femoral neck fracture patients treated with internal fixation. Patient characteristics and healthcare consumption were collected. Total follow-up was two years. A societal perspective was adopted. Costs included hospital costs during primary stay and follow-up, and costs related to rehabilitation and changes in living situation.Costs were compared between non-revision surgery patients, implant removal patients, and revision arthroplasty patients.Results: A total of 248 patients were included (mean age 71 years). Mean total costs per patient at two years follow-up were €19,425. In the non-revision surgery patients total costs were €17,405 (N=137), in the implant removal patients €10,066 (N=38), and in the revision arthroplasty patients €26,733 (N=67). The main contributing costs were related to the primary surgery, admission days, physical therapy, and revision surgeries. Conclusions:The main determinant was the costs of admission to a rehabilitation center/nursing home. Costs were specifically high in elderly with comorbidity, who were less independent pre-fracture, and have a longer admission to the hospital and/or a nursing home.Costs were also higher in revision surgery patients. The two years follow-up costs in our study were comparable to published costs in other Western societies.

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Section: Discussioncontrasting

confidence: 40%

Section: Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The societal costs of femoral neck fracture patients treated with internal fixation

Zielinski

Bouwmans²,

Heetveld

et al. 2013

Osteoporos Int

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“…Conflicting results have been reported about the surgical treatment costs of proximal femoral fractures. [16,17] Although cost of first operation was lower in hemiarthroplasty group, there was no significant difference between the groups when we added the four patients who underwent revision operation in hemiarthroplasty group.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of proximal femoral nail-antirotation and cemented, bipolar hemiarthroplasty with calcar replacement in treatment of intertrochanteric femoral fractures in terms of mortality and morbidity ratios

Esen

Dur

Ataoğlu

et al. 2017

Eklem Hastalik Cerrahisi

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ÖZAmaç: Bu çalışmada proksimal femoral çivi-antirotasyon (PFNA) veya çimentolu, kalkar destekli, bipolar hemiartroplasti uygulanan intertrokanterik femur kırıklı hastaların mortalite ve morbidite oranları değerlendirildi. Hastalar ve yöntemler: Proksimal femur kırığı nedeniyle Ocak 2008 -Ocak 2011 tarihleri arasında tedavi gören 127 hasta (42 erkek, 85 kadın; ort. yaş 79.2 yıl; dağılım 55-98 yıl) ameliyat sırasında mortalite, toplam mortalite ve mortalite oranlarının aylara göre dağılımı açısından retrospektif olarak karşılaştırıldı. Bu 127 hastadan yaşayan, en az 12 aylık takibe ulaşan, ameliyat öncesi dönemde yürüyebilen ve günlük aktivitelerini yerine getirebilen 92 hasta (28 erkek, 64 kadın; ort. yaş 80.24 yıl; dağılım 55-94 yıl) çalışmaya dahil edildi. Hastalar PFNA grubu (n=34) ve çimentolu, kalkar destekli, bipolar hemiartroplasti grubu (hemiartroplasti grubu; n=58) olmak üzere iki gruba ayrıldı. Her iki grup ameliyat süresi, ameliyat sırasında kan transfüzyonu ihtiyacı, hastanede yatış süresi, fonksiyonel sonuçlar, yaşam kalitesi, komplikasyon ve revizyon oranları ve ameliyat maliyetleri açısından karşılaştırıldı. Bulgular: Her iki gruptaki hastalarda aynı kırık tipi vardı. İki grubun kemik mineral yoğunluğu sonuçları, anestezi tipi ve riski benzerdi. İki grup arasında ameliyat sırasında mortalite, toplam mortalite ve mortalite oranlarının aylara göre dağılımı açısından anlamlı farklılık saptanmadı (p>0.05). Ortalama ameliyat süresi PFNA ve hemiartroplasti gruplarında sırasıyla 54.84 dakika (dağılım 40-110 dakika) ve 74.66 dakika (dağılım 55-120 dakika) idi. Ortalama hastanede yatış süresi PFNA ve hemiartroplasti gruplarında sırasıyla 5.91 gün (dağılım 5-12 gün) ve 9.41 gün (dağılım 6-16 gün) idi. Proksimal femoral çivi-antirotasyon grubunda ameliyat süresi ve hastanede yatış süresi daha kısa; fonksiyonel sonuçlar daha iyi idi (p<0.05). Kan transfüzyonu ihtiyacı PFNA grubunda daha az idi. Sonuç: İntertrokanterik femur kırıklarının tedavisinde hem PFNA hem çimentolu, kalkar destekli, bipolar hemiartroplasti iyi tekniklerdir. Yaşlı hastalarda ameliyat süresinin daha kısa ve tekrar ameliyat riskinin düşük olması nedeniyle internal tespit daha uygun olabilir.Anahtar sözcükler: Hemiartroplasti; kalça kırığı; intertrokanterik femur kırığı; proksimal femoral çivi-antirotasyon. ABSTRACTObjectives: This study aims to assess the mortality and morbidity rates of patients with intertrochanteric femoral fractures who were performed proximal femoral nail-antirotation (PFNA) or cemented, bipolar hemiarthroplasty with calcar replacement. Patients and methods:A total of 127 patients (42 males, 85 females; mean age 79.2 years; range 55 to 98 years) who were treated due to proximal femoral fracture between January 2008 and January 2011 were compared retrospectively in terms of intraoperative mortality, total mortality, and monthly distribution of mortality rates. Of these 127 patients, 92 (28 males, 64 females; mean age 80.24 years; range 55 to 94 years) who were alive, who achieved at least a 12-month follow-up, and could...

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“…The authors concluded that taking into account complication rates, mortality, revision surgeries and functional outcome, THA is the most cost effective treatment option for femoral neck fractures in the elderly. The current costs of treatment for femoral neck fractures in the elderly in Northern Europe have been analysed by Frihagen et al (Frihagen et al, 2010). They randomised 222 patients with an average age of 83 years to internal fixation or hemiarthroplasty.…”

Section: Costmentioning

confidence: 99%

Hip Fracture in the Elderly: Partial or Total Arthroplasty?

Fokter¹,

Fokter²

2012

Recent Advances in Hip and Knee Arthroplasty

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The cost of hemiarthroplasty compared to that of internal fixation for femoral neck fractures

Cited by 40 publications

References 14 publications

The societal costs of femoral neck fracture patients treated with internal fixation

The societal costs of femoral neck fracture patients treated with internal fixation

Evaluation of proximal femoral nail-antirotation and cemented, bipolar hemiarthroplasty with calcar replacement in treatment of intertrochanteric femoral fractures in terms of mortality and morbidity ratios

Hip Fracture in the Elderly: Partial or Total Arthroplasty?

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