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Total hip arthroplasty or hemiarthroplasty for femoral neck fractures in elderly patients with neuromuscular imbalance

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Abstract

Aim

This study aimed at comparing clinical outcomes between total hip arthroplasty (THA) and hemiarthroplasty (HA) in elderly patients with neuromuscular imbalance (stroke, Parkinsonism, etc.).

Methods

A total of 226 elderly patients with neuromuscular imbalance and femoral neck fractures treated with THA or HA were recruited at a single center, and their clinical data retrospectively reviewed. Mean follow-up time was 40.5 months (range 24–78), the primary outcome was secondary hip procedure while secondary outcomes included function, pain, health-related quality of life, complications, and death. Kaplan–Meier survival curves were used to determine the estimated survivorship, with re-operation as the end point. Logistic regression analyses were performed to assess the effects of different surgical procedures on mortality while linear regression analysis was used to evaluate the function, pain and quality of life.

Results

Kaplan–Meier survivorship, with an end point of re-operation for any reason in the THA group, was 90.3% (95% CI 82.3–98.3), which was not significantly different from 95.9% (95% CI 93.0–98.8) for the HA group (p = 0.137). The most common cause of re-operation in both groups was dislocation. There were no significant differences with regards to postoperative complications (including dislocation). Compared to HA, THA exhibited better functional outcomes, quality of life and low pain intensity. Notably, there was no difference in 2 year mortality rates between the groups, however, HA was associated with a higher mortality rate beyond 2 years (OR 0.137; 95% CI 0.030–0.630; p = 0.011).

Conclusion

THA is an effective therapeutic procedure for femoral neck fractures in elderly patients with neuromuscular imbalance.

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Data availability

Available upon reasonable request to the corresponding author.

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Acknowledgements

The authors thank Dr. Junzhe Zhang for valuable statistic advice concerning this study and Dr. Sifan Yang for guidance on the graphs of this study.

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Author notes

  1. Yuchuan Wang and Xiangtian Deng contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Yuchuan Wang, Zhongzheng Wang, Yanbin Zhu, Wei Chen & Yingze Zhang

  2. Orthopaedic Institution of Hebei Province, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Yuchuan Wang, Zhongzheng Wang, Yanbin Zhu, Wei Chen & Yingze Zhang

  3. Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Yuchuan Wang, Zhongzheng Wang, Yanbin Zhu, Wei Chen & Yingze Zhang

  4. NHC Key Laboratory of Intelligent Orthopaedic Equipment, Shijiazhuang, 050051, Hebei, People’s Republic of China

    Yuchuan Wang, Zhongzheng Wang, Yanbin Zhu, Wei Chen & Yingze Zhang

  5. Chinese Academy of Engineering, Beijing, 100088, People’s Republic of China

    Yingze Zhang

  6. School of Medicine, Nankai University, Tianjin, 300071, People’s Republic of China

    Xiangtian Deng

Authors
  1. Yuchuan Wang
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Contributions

YZ contributed to the study conception and design. Material preparation, data collection and analysis were performed by YW, XD and ZW. The first draft of the manuscript was written by YW. XD, YZ and WC commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yingze Zhang.

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Conflict of interest

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Ethical approval

The study was approved by the Ethics Committee of the Third Hospital of Hebei Medical University.

Informed consent

All participants provided informed consent prior to their participation.

Statement of human and animal rights

This study does not contain any studies with animals performed by any of the authors and complies with guidelines for human studies.

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Wang, Y., Deng, X., Wang, Z. et al. Total hip arthroplasty or hemiarthroplasty for femoral neck fractures in elderly patients with neuromuscular imbalance. Aging Clin Exp Res 34, 2825–2833 (2022). https://doi.org/10.1007/s40520-021-01976-y

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  • DOI: https://doi.org/10.1007/s40520-021-01976-y

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