Comparison of Total Hip Arthroplasty (THA) and Hemiarthroplasty (HA) in Femoral Neck Fractures of Elderly Patients

Abstract

Femoral neck fracture is a common problem among the elderly. There is no cure for these fractures until now. Internal fixation, hemi arthroplasty and total arthroplasty are widely used methods for treating these fractures. The purpose of this study was to compare two techniques of arthroplasty and total hemiarthroplasty in femoral neck fractures in the elderly. This clinical trial had been performed among the elderly over 65 years with a diagnosis of femoral neck fracture, hip replacement surgery. They were randomly assigned to two groups (n = 50) of hemiarthroplasty and total hip arthroplasty. Duration of surgery, intraoperative blood loss, and duration of hospitalization were analyzed. Patients Follow up were performed once a month for six months and then quarterly for a year after study. Hip function of patients were assessed using the Harris hip score in the fourth and twelve months after surgery. The rate of intraoperative bleeding and the mean duration of surgery was lower in hemiarthroplasty than THA group (P = 0.01). The mean pain score in patients with total hip arthroplasty after 6month was 38 and after 12 months was 43. In Hemiarthroplasty group, the pain intensity score after 6 months was 40 and after 12 month was 42 (P = 0.04). Average functional score and activity of hip joint in total arthroplasty group was 31.5 (47-5) after six months, and 35.3 (47-8) in yearly follow up, and in hemiarthroplasty group, it was 28 (45-5) and 32 (47-8), respectively (P = 0.028). This study results shows that treatment of femoral neck fractures in elderly through total hip arthroplasty surgery lead to a better results in terms of knee function and also less pain and fewer complications in the one-year follow-up.