Key result
Total hip replacement provided significantly better hip function at 12 months compared to internal fixation (Harris score 90.65 vs 81.06, p<0.0001), despite longer operation times and increased blood loss.
Why the study?
Does total hip replacement improve clinical outcomes compared to internal fixation in elderly patients with Garden I or II femoral neck fractures?
Cohort (n=79)
No
Does total hip replacement improve clinical outcomes compared to internal fixation in elderly patients with Garden I or II femoral neck fractures?
Total hip replacement provides better functional outcomes and fewer complications than internal fixation for elderly patients with Garden I/II femoral neck fractures, despite increased surgical time and blood loss.
Answers are grounded in this paper and cite their sources.
THR was associated with better 12-month function; leaves open whether to change practice in Garden I/II fractures pending RCTs.
Background: To evaluate the effects of total hip replacement and internal fixation on the outcome of femoral neck fractures in the elderly. Methods: A retrospective study was conducted in a total of 79 individuals diagnosed with Garden I or Garden II femoral neck fractures aged from 56-71 years old from October 2012 to May 2019. Patients treated with total hip replacement were grouped into group 1, while those treated with internal fixation were grouped into group 2. Baseline characteristics were compared between the two groups to eliminate extra factors. Postoperative activity time, blood loss, length of hospital stay, and length of surgical incision were compared between the two groups. Besides, postoperative complications and hip function (Harris score) were detected to evaluate the final effects in the two groups. Results: Baseline characteristics were similar between the groups, but the mean duration of surgery was more in group 1 than that in group 2 ( p <0.0001). Blood loss and length of surgical incision were both larger in group 1. However, the incidence of such postoperative complications as lung infection, urinary tract infection and thrombosis of lower limb was lower in group 1 compared with those in group 2. Moreover, the hip function (Harris score) was also better after total hip replacement compared with that after internal fixation. Conclusions: Total hip replacement provides satisfactory clinical outcomes, but with longer operation time and increased blood loss compared with internal fixation.
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Xu et al. (2019) conducted a cohort in Garden I or II femoral neck fractures (n=79). Total hip replacement vs. Internal fixation was evaluated on Hip function (Harris score) at 12 months (p=<0.0001). Total hip replacement provided significantly better hip function at 12 months compared to internal fixation (Harris score 90.65 vs 81.06, p<0.0001), despite longer operation times and increased blood loss.
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