Abstract
BackgroundThe influence of pre-existing radiographic osteoarthritis on the functional outcome of elderly patientents with displaced intracapsular fractures of the femoral neck treated by hemiarthroplasty is unclear.MethodsWe prospectively examined the impact of pre-existing osteoarthritis on the functional outcome of 126 elderly patients with displaced intracapsular fracture of the femoral neck treated by hemiarthroplasty.ResultsThe mean age of the cohort was 82.7 years. At 12 months, we observed no statistically significant differences in the Harris hip score (p = 0.545), the timed up and go test (p = 0.298), the Tinetti test (p = 0.381) or the Barthel Index (p = 0.094) between patients with Kellgren and Lawrence grades 3 or 4 osteoarthritis, and patients with grades 0 to 2 changes. Furthermore, there were no differences in complication or revision rates.ConclusionsOur findings challenge the hypothesis that pre-existing osteoarthritis is a contraindication to hemiarthroplasty in elderly patients with femoral neck fracture.
Highlights
The influence of pre-existing radiographic osteoarthritis on the functional outcome of elderly patientents with displaced intracapsular fractures of the femoral neck treated by hemiarthroplasty is unclear
We examined the influence of pre-existing radiographic osteoarthritis of the hip on the short-term functional outcome after hemiarthroplasy for displaced femoral neck fracture in elderly patients
We found no significant association between the pre-existing grade of osteoarthritis and the primary and secondary functional outcome measures
Summary
The influence of pre-existing radiographic osteoarthritis on the functional outcome of elderly patientents with displaced intracapsular fractures of the femoral neck treated by hemiarthroplasty is unclear. The best strategy for the treatment of displaced femoral neck fracture in elderly patients remains unclear. Because of high revision rates, the concept of reduction and internal fixation has been superseded by endoprosthetic replacement of the femoral head and neck [1]. Pre-existing radiographic osteoarthritis of the affected hip is considered by some to be a contraindication for hemiarthroplasy, because of the risk of acetabular erosion and the subsequent need for revision [9]. Given the high prevalence of radiographic osteoarthritis of the hip in elderly individuals [10], this substantially limits the clinical applicability of hemiarthroplasy in the treatment of femoral neck fracture
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