HEALTH

Full title

Hip fracture Evaluation with Alternatives of Total Hip arthroplasty versus hemi-arthroplasty

Background

Hip fractures are extremely common in the United Kingdom.

Due to the ageing population, the number of hip fractures is expected to increase. Hip fractures can lead to temporary, sometimes permanent, loss of independence and can affect quality of life. Hip fractures account for more hospital days than any other fractures in the body.

Femoral neck fractures are a common type of fracture of the hip. The hip joint connects the thighbone (femur) with the pelvis. Despite the name hip fracture, the break is below the hip joint, at one of two places at the upper end of the thighbone.

Following the break, severe pain occurs in the hip, groin, and thigh. It is usually impossible to get up or walk. Very occasionally when the bone is cracked rather than completely broken, walking is possible but painful.

What we did

The study is to compare the two common types of joint replacement.

1. Total hip replacement (arthroplasty).
2. Hemiarthroplasty.

We randomly assigned 1495 patients to receive a total hip replacement (718 patients) or a hemiarthroplasty (723 patients).

What we found

Hip instability or dislocation occurred in 4.7% of total hip replacement patients (4.7%) and 2.4% of hemiarthroplasty patients.

Function, as measured with the total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, pain score, stiffness score, and function score, modestly favoured total hip replacement over hemiarthroplasty.

Mortality was similar in the two groups (14.3% total hip arthroplasty versus 13.1% hemiarthroplasty).

Serious adverse events occurred in 41.8% total hip replacement patients and in 36.7% hemiarthroplasty patients.

Co-chief investigators

Mohit Bhandari and Thomas Eihnorn

Sponsor

McMaster University

Funder

Canadian Institute of Health Research

Study status

Published

ClinicalTrials.gov identifier