Hemiarthroplasty in the treatment of proximal femur fractures: mortality rates, implant survival, and acetabular erosion
Joana Isabel Rodrigues Ribeiro, Pedro Francisco Casal Soares de Brito, Linda Inês Aparício Chorão, Virgínia do Amaral, João Alves, Rui Miguel Fernandes Duarte, Ana Isabel Costa RibauAbstract
Background:
The surgical treatment of proximal femur fractures (PFFs) in the elderly is between total hip arthroplasty, preferred in younger and more active patients, and hemiarthroplasty. The increasing number of PFFs, associated with high morbidity and mortality rates and socioeconomic impact, makes it essential to assess the outcomes and complications of the treatments used. Our goal was to analyze patient survival, hemiarthroplasty survival, and acetabular erosion rates in patients who underwent hip hemiarthroplasty due to PFFs.
Methods:
This retrospective 6-year study (2018–2023) included 258 patients who underwent bipolar hip hemiarthroplasty at a single level 2 trauma center for PFFs. Demographic data and perioperative and postoperative variables were retrieved from clinical records.
Results:
The median age was 85 years, with 74.4% of patients being female. In-hospital complications occurred in 50.8% of patients. Prosthetic dislocation occurred in 8.14%, infection in 0.775%, and periprosthetic fracture in 1.55% of patients. The 1-year survival rate for patients was 73.5%, while the prosthetic survival rate was 95.3%. None of the patients required revisions due to acetabular erosion. Multivariate analysis showed that, when compared with the bedridden status, assisted-walking status was influenced by the absence of dementia (
Conclusions:
Hemiarthroplasty was a good solution for selected patients, given the high prosthetic survival in a population with a high burden of comorbidities and mortality.