Total and Partial Hip Arthroplasty After Fracture Have Similar Reoperation Rates

By Kelly Young

Edited by André Sofair, MD, MPH

Patients undergoing total or partial hip arthroplasty have similar reoperation rates after 2 years, according to a study presented at the Orthopedic Trauma Association’s annual meeting and published in the New England Journal of Medicine. The research was supported, in part, by industry funding.

Researchers studied roughly 1500 patients aged 50 and older who planned to have surgery for displaced fracture of the femoral neck and were independently ambulatory before the fracture. Patients were randomized to either total hip arthroplasty or hemiarthroplasty. Total arthroplasty involves replacing both the acetabulum and femoral head, while hemiarthroplasty replaces just the femoral head.

The primary endpoint — any unplanned hip surgery within 24 months — was statistically similar in the groups, at around 8%. Function scores were higher in the total arthroplasty group, but not at a level that was considered clinically meaningful.

The authors write: “Our findings suggest that the advantages of total hip arthroplasty may not be compelling.”