Total hip replacement for the treatment of acute femoral neck fractures: results from the National Joint Registry of England and Wales at 3-5 years after surgery

Ann R Coll Surg Engl. 2012 Apr;94(3):193-8. doi: 10.1308/003588412X13171221589720.

Abstract

Introduction: This paper describes, for the first time, the outcomes of patients undergoing total hip replacement for acute fractured neck of femur (#NOF) as recorded by the National Joint Registry of England and Wales (NJR).

Methods: In the NJR we identified 1,302 of 157,232 Hospital Episode Statistics linked patients who had been recorded as having a total hip replacement for acute #NOF between April 2003 and November 2008.

Results: The revision rate at five years for fully uncemented components was 4.1% (95% confidence interval [CI]: 2.2-7.3%), for hybrid it was 2.2% (95% CI: 0.9%-5.3%) and for fully cemented components 0.9% (95% CI: 0.4-2.0%). Five-year revision rates were increased for those whose operations were performed via a posterior versus a lateral approach. The Kaplan-Meier estimate of 30-day mortality was 1.4% (95% CI: 1.0-2.4%), which is over double the 30-day mortality rate for total hip replacement identified by the Office for National Statistics. The mean length of stay was also increased for those undergoing total hip replacements for #NOF compared with non-emergency indications.

Conclusions: Our data suggest that total hip replacements for acute #NOF give comparable results with total hip replacements for other indications.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / mortality
  • Arthroplasty, Replacement, Hip / statistics & numerical data*
  • Comorbidity
  • England / epidemiology
  • Female
  • Femoral Neck Fractures / epidemiology
  • Femoral Neck Fractures / mortality
  • Femoral Neck Fractures / surgery*
  • Hip Prosthesis / statistics & numerical data
  • Humans
  • Kaplan-Meier Estimate
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Prosthesis Design / mortality
  • Prosthesis Design / statistics & numerical data
  • Registries
  • Reoperation / mortality
  • Reoperation / statistics & numerical data
  • Wales / epidemiology