Purpose: Hip hemiarthroplasty (HA) is a commonly performed operation. A post-operative radiograph forms part of the routine hip fracture pathway, although patients are often mobilised prior to this investigation. This study seeks to provide evidence for a pragmatic clinical change to optimise patient safety and allocate limited resources within the National Health Service (NHS).
Methods: We undertook a retrospective database review of 1563 HA procedures to assess whether the routine ordering of check radiographs played an important role in a patient's post-operative care.
Results: 18 (1.2%) mechanical complications led to a return to theatre within 6 weeks of the index procedure. All were dislocations. Ten had a normal post-operative radiograph and five had documented suspicion of dislocation prior to radiography. The post-operative check radiograph was the sole identifier of dislocation in only three patients (0.2%). All three of these patients were pre-morbidly bed bound and non-communicative due to cognitive impairment (AMTS 0/10).
Conclusion: Unless a patient is pre-morbidly bed bound and cognitively impaired, routine post-operative radiography following HA surgery is of little clinical benefit, yet may carry considerable risk to the patient and cost to the NHS. A pragmatic compromise is to perform intra-operative fluoroscopic imaging.
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http://dx.doi.org/10.1007/s00068-021-01605-3 | DOI Listing |
J Orthop Trauma
December 2024
Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, New York, NY.
Objectives: To determine the most common reason for 30-day readmission following hospitalization for hip fractures.
Methods: Design: A retrospective review.
Setting: Single academic medical center that includes a Level 1 Trauma Center.
Cureus
December 2024
Trauma and Orthopaedics, William Harvey Hospital, Ashford, GBR.
Background: Femoral neck fractures in elderly individuals cause significant morbidity, and their management is particularly challenging in rural areas where healthcare access is limited. The recommended treatment for displaced femoral neck fractures in elderly patients with poor mobility, cognitive dysfunction and multiple comorbidities is a hemiarthroplasty, which can be performed with various implants, including monopolar implants like Austin Moore prosthesis (AMP) and bipolar prosthesis (BP). In developing countries like India, rural areas often have constraints with healthcare resources.
View Article and Find Full Text PDFHip Pelvis
December 2024
Department of Orthopedic Surgery, Geisinger Medical Center, Danville, PA, USA.
Bone Joint J
December 2024
Department of Orthopaedics, Xiangya Hospital Central South University, Changsha, China.
Aims: For displaced femoral neck fractures (FNFs) in geriatric patients, there remains uncertainty regarding the effect of total hip arthroplasty (THA) compared with hemiarthroplasty (HA) in the guidelines. We aimed to compare 90-day surgical readmission, in-hospital complications, and charges between THA and HA in these patients.
Methods: The Hospital Quality Monitoring System was queried from 1 January 2013 to 31 December 2019 for displaced FNFs in geriatric patients treated with THA or HA.
: Acetabular erosion is a postoperative condition that can occur after hip hemiarthroplasty (HA), potentially leading to pain and requiring conversion to total hip arthroplasty (THA). Given the discrepancy in its incidence and impact in the literature, this study aims to report the incidence of symptomatic acetabular erosion and the subsequent conversion to THA in all HA cases performed in a single health system. : A total of 2477 HA cases had their clinical notes and serial radiographs examined for this retrospective study.
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