AI Article Synopsis
- The study aimed to evaluate if total hip arthroplasty (THA) could improve health-related quality of life (HRQoL) after an intracapsular hip fracture, while also looking at hip function, fitness, mortality risk, and complications.
- Researchers analyzed data from 250 patients aged 50 and older who had hip fractures, noting demographic details, complications, and patient-reported outcomes over an average follow-up of 2.3 years.
- Results showed a high 2-year implant and patient survival rate of 95.5%, but significant health deteriorations were noted post-surgery, especially associated with older age and male sex, highlighting the risks and varying success of THA in restoring pre-fracture
Article Abstract
Purpose: The primary aim was to assess whether a total hip arthroplasty (THA) was able to restore health-related quality of life (HRQoL) following an intracapsular hip fracture. The secondary aims were to assess changes in hip-specific function, fitness/frailty, mortality risk, complications and revision risk, and factors independently associated with these.
Methods: This retrospective cohort study included all patients aged ≥ 50 years admitted with a hip fracture from the emergency department at a single centre during a 42-month period. Patient demographics, perioperative variables, complications, revision, and mortality were collected. Patient-reported outcome measures (PROMs) were assessed at final follow-up.
Results: Among 250 identified patients, 189 (75.6%) were women with a mean age of 70.3 (range 50-94 years). Mean follow-up was 2.3 (SD 1.1) years. The implant and patient survival rates at 2 years were both 95.5% (95% confidence intervals (CI) +/- 2.7). Older age (hazard ratio [HR] 1.22, 95% CI 1.12-1.33, p < 0.001) and male sex (HR 3.33, 95% CI 1.15-10.0, p = 0.026) were independently associated with mortality. There were 19 (7.6%) postoperative complications that included 6 (2.4%) periprosthetic fractures, 5 (2.0%) deep infections, and 8 (3.2%) dislocations, of which 13 underwent revision. Increasing time to theatre (HR 1.02, 95% CI 1.01-1.03, p = 0.017) was independently associated with a postoperative complication. Postoperative PROMs were available for 166 (66.4%) patients. There were significant (p < 0.001) deteriorations in EuroQol-5D (Mean difference [MD] 0.192, 95% CI 0.133-0.252), Oxford hip score (MD 2.5, 95% CI 1.5-3.6), and fitness (Rockwood score MD 0.7, 95% CI 0.5-0.8) relative to preoperative levels of function.
Conclusion: THA may be the treatment of choice in a physically active patient with the aim of restoring their HRQoL, hip function, and fitness, but this was not observed. Furthermore, there was a high complication rate which was associated with increasing time to theatre.
Level Of Evidence: III, retrospective cohort study.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377460 | PMC |
| http://dx.doi.org/10.1007/s00590-024-04034-1 | DOI Listing |
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