How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures?
Abstract. Objectives:. To evaluate functional outcomes amongst femoral neck fracture trial participants who did not undergo reoperation. Design:. Secondary analysis of 2 randomized controlled trials. Setting:. Ninety hospitals in 5 continents. Participants:. Patients aged 50 years or older with a fe...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-06-01
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| Series: | OTA International |
| Online Access: | http://journals.lww.com/10.1097/OI9.0000000000000404 |
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| author | Zafar Ahmad, MD Daniel Axelrod, MD, MSc Marianne Comeau-Gauthier, MD, MSc Sofia Bzovsky, MSc Rudolf W. Poolman, MD, PhD Frede Frihagen, MD, PhD, FRCSC Mohit Bhandari, MD, PhD, FRCSC Marc Swiontkowski, MD Sheila Sprague, PhD Emil Schemitsch, MD, FRCSC |
| author_facet | Zafar Ahmad, MD Daniel Axelrod, MD, MSc Marianne Comeau-Gauthier, MD, MSc Sofia Bzovsky, MSc Rudolf W. Poolman, MD, PhD Frede Frihagen, MD, PhD, FRCSC Mohit Bhandari, MD, PhD, FRCSC Marc Swiontkowski, MD Sheila Sprague, PhD Emil Schemitsch, MD, FRCSC |
| author_sort | Zafar Ahmad, MD |
| collection | DOAJ |
| description | Abstract. Objectives:. To evaluate functional outcomes amongst femoral neck fracture trial participants who did not undergo reoperation.
Design:. Secondary analysis of 2 randomized controlled trials.
Setting:. Ninety hospitals in 5 continents.
Participants:. Patients aged 50 years or older with a femoral neck fracture.
Intervention:. Arthroplasty, including total hip arthroplasty and hemiarthroplasty, or internal fixation, including sliding hip screw or multiple cancellous screws.
Main Outcome Measurement:. The Western Ontario and McMaster University Arthritis Index (WOMAC) and 12-item Short Form Health Survey (SF-12) physical component summary (PCS).
Results:. Data from 716 arthroplasty patients and 549 internal fixation patients were included in our propensity score weighting model. Internal fixation patients had higher WOMAC stiffness scores (leading to poorer function) at 24 months postoperatively compared with total hip arthroplasty patients (adjusted mean difference [AMD] 0.42 points, 99% confidence interval [CI] 0.09–0.75; P < 0.001) and hemiarthroplasty patients (AMD 0.39 points, 99% CI 0.04–0.74; P = 0.004). However, this statistically significant difference did not reach the 7-point threshold for a minimal clinically important difference. No statistically significant differences were found in the other WOMAC scales, nor with the SF-12 PCS. In participants aged 70 years or younger, no difference was found in any of the functional outcomes at 24 months.
Conclusion:. While stiffness is worse following internal fixation, our results show similar functional outcomes in femoral neck fracture patients undergoing modern methods of internal fixation versus arthroplasty. These results, however, may not be applicable to a younger, more active hip fracture population.
Level of Evidence:. Prognostic Level II. |
| format | Article |
| id | doaj-art-2d15d046b5944b5fb688ed889496b70c |
| institution | Kabale University |
| issn | 2574-2167 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | OTA International |
| spelling | doaj-art-2d15d046b5944b5fb688ed889496b70c2025-08-20T03:47:21ZengWolters KluwerOTA International2574-21672025-06-018210.1097/OI9.0000000000000404OI90000000000000404How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures?Zafar Ahmad, MD0Daniel Axelrod, MD, MSc1Marianne Comeau-Gauthier, MD, MSc2Sofia Bzovsky, MSc3Rudolf W. Poolman, MD, PhD4Frede Frihagen, MD, PhD, FRCSC5Mohit Bhandari, MD, PhD, FRCSC6Marc Swiontkowski, MD7Sheila Sprague, PhD8Emil Schemitsch, MD, FRCSC9a Department of Surgery, Western University, London, ON, Canadab Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canadab Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canadab Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canadac Department of Orthopedic Surgery, OLVG, Amsterdam and LUMC, Leiden, the Netherlandsd Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norwayb Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canadag Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN.b Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canadaa Department of Surgery, Western University, London, ON, CanadaAbstract. Objectives:. To evaluate functional outcomes amongst femoral neck fracture trial participants who did not undergo reoperation. Design:. Secondary analysis of 2 randomized controlled trials. Setting:. Ninety hospitals in 5 continents. Participants:. Patients aged 50 years or older with a femoral neck fracture. Intervention:. Arthroplasty, including total hip arthroplasty and hemiarthroplasty, or internal fixation, including sliding hip screw or multiple cancellous screws. Main Outcome Measurement:. The Western Ontario and McMaster University Arthritis Index (WOMAC) and 12-item Short Form Health Survey (SF-12) physical component summary (PCS). Results:. Data from 716 arthroplasty patients and 549 internal fixation patients were included in our propensity score weighting model. Internal fixation patients had higher WOMAC stiffness scores (leading to poorer function) at 24 months postoperatively compared with total hip arthroplasty patients (adjusted mean difference [AMD] 0.42 points, 99% confidence interval [CI] 0.09–0.75; P < 0.001) and hemiarthroplasty patients (AMD 0.39 points, 99% CI 0.04–0.74; P = 0.004). However, this statistically significant difference did not reach the 7-point threshold for a minimal clinically important difference. No statistically significant differences were found in the other WOMAC scales, nor with the SF-12 PCS. In participants aged 70 years or younger, no difference was found in any of the functional outcomes at 24 months. Conclusion:. While stiffness is worse following internal fixation, our results show similar functional outcomes in femoral neck fracture patients undergoing modern methods of internal fixation versus arthroplasty. These results, however, may not be applicable to a younger, more active hip fracture population. Level of Evidence:. Prognostic Level II.http://journals.lww.com/10.1097/OI9.0000000000000404 |
| spellingShingle | Zafar Ahmad, MD Daniel Axelrod, MD, MSc Marianne Comeau-Gauthier, MD, MSc Sofia Bzovsky, MSc Rudolf W. Poolman, MD, PhD Frede Frihagen, MD, PhD, FRCSC Mohit Bhandari, MD, PhD, FRCSC Marc Swiontkowski, MD Sheila Sprague, PhD Emil Schemitsch, MD, FRCSC How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures? OTA International |
| title | How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures? |
| title_full | How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures? |
| title_fullStr | How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures? |
| title_full_unstemmed | How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures? |
| title_short | How does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures? |
| title_sort | how does internal fixation compared with arthroplasty affect quality of life for patients who have suffered femoral neck fractures |
| url | http://journals.lww.com/10.1097/OI9.0000000000000404 |
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