Complications of Hip Hemiarthroplasty in Patients with Epilepsy: A Retrospective Analysis of 69 Cases

(1) Background: Neurological and cognitive disorders increase with age, raising risks of falls, poor bone health, and hip fractures. While previous studies found increased complications of hip arthroplasty in neurologic disorders in general, no studies have specifically focused on hip hemiarthroplasty (HA) for femoral neck fractures in patients with epilepsy. This retrospective study aimed to evaluate the outcomes of HA in hip fracture patients with epilepsy. (2) Methods: After IRB approval, all HA cases performed in our multi-hospital health system were reviewed. Included were patients who underwent HA for hip fracture and had a documented diagnosis of epilepsy. Cases with missing follow-up data or secondary epilepsy due to associated neurological conditions were excluded. A total of 69 cases (68 patients) were included. (3) Results: The cohort included 43 females and 25 males, with a mean age of 73.7 years. After a mean follow-up of 58.1 months, complications included prosthetic joint infections (8.7%), periprosthetic fractures (8.7%), acetabular erosion (1.45%), and dislocation (1.45%). Mortality rates were 4.4% at 3 months, 16.18% at 12 months, and 38.24% at 3 years. Given the retrospective, non-comparative design and small sample size, these findings are descriptive and do not establish causality between epilepsy and complication risk. (4) Conclusions: Periprosthetic fractures and prosthetic joint infections were the most common complications after HA in patients with epilepsy. Larger multicenter studies are recommended.