High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patients
Background and purpose — Most often, the goal of non-geriatric femoral neck fracture surgery is to preserve the native hip joint. However, reoperations for painful implants, osteonecrosis, and nonunion are common. We determined the reoperation rate and time-to-reoperation following internal fixation...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2019-01-01
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| Series: | Acta Orthopaedica |
| Online Access: | http://dx.doi.org/10.1080/17453674.2018.1558380 |
| _version_ | 1798019215290007552 |
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| author | David J Stockton Lyndsay M O’Hara Nathan N O’Hara Kelly A Lefaivre Peter J O’Brien Gerard P Slobogean |
| author_facet | David J Stockton Lyndsay M O’Hara Nathan N O’Hara Kelly A Lefaivre Peter J O’Brien Gerard P Slobogean |
| author_sort | David J Stockton |
| collection | DOAJ |
| description | Background and purpose — Most often, the goal of non-geriatric femoral neck fracture surgery is to preserve the native hip joint. However, reoperations for painful implants, osteonecrosis, and nonunion are common. We determined the reoperation rate and time-to-reoperation following internal fixation of these fractures in a large population cohort. Patients and methods — This retrospective cohort study included patients between the ages of 18 and 50 years old who underwent internal fixation for a femoral neck fracture during 1997–2013. Patients were followed until December 2013. Primary outcomes were reoperation rate and time-to-reoperation. Time-to-event analysis was performed to estimate the rate of any reoperation and for THA specifically, while testing the dependency of time-to-reoperation on secondary variables. Results — 796 young femoral neck fracture patients were treated with internal fixation during the study period (median age 43 years, 39% women). Median follow-up was 8 years (IQR 4–13). One-third underwent at least 1 reoperation at a median 16 months after the index surgery (IQR 8–31). Half of reoperations were for implant removal, followed by conversion to total hip arthroplasty. 14% of the cohort were converted to THA. The median time to conversion was 2 years (IQR 1–4). Neither female sex nor older age had a statistically significant effect on time-to-reoperation or time-to-THA conversion. Interpretation — Following internal fixation of young femoral neck fracture, 1 in 3 patients required a reoperation, and 1 in 7 were converted to THA. These data should be considered by patients and surgeons during treatment decision-making. |
| first_indexed | 2024-04-11T16:36:48Z |
| format | Article |
| id | doaj.art-4fbe38cad789477aacc50e91d7acf522 |
| institution | Directory Open Access Journal |
| issn | 1745-3674 1745-3682 |
| language | English |
| last_indexed | 2024-04-11T16:36:48Z |
| publishDate | 2019-01-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Acta Orthopaedica |
| spelling | doaj.art-4fbe38cad789477aacc50e91d7acf5222022-12-22T04:13:47ZengMedical Journals SwedenActa Orthopaedica1745-36741745-36822019-01-01901212510.1080/17453674.2018.15583801558380High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patientsDavid J Stockton0Lyndsay M O’Hara1Nathan N O’Hara2Kelly A Lefaivre3Peter J O’Brien4Gerard P Slobogean5University of British ColumbiaUniversity of MarylandUniversity of Maryland, R Adams Cowley Shock Trauma CenterUniversity of British ColumbiaUniversity of British ColumbiaUniversity of Maryland, R Adams Cowley Shock Trauma CenterBackground and purpose — Most often, the goal of non-geriatric femoral neck fracture surgery is to preserve the native hip joint. However, reoperations for painful implants, osteonecrosis, and nonunion are common. We determined the reoperation rate and time-to-reoperation following internal fixation of these fractures in a large population cohort. Patients and methods — This retrospective cohort study included patients between the ages of 18 and 50 years old who underwent internal fixation for a femoral neck fracture during 1997–2013. Patients were followed until December 2013. Primary outcomes were reoperation rate and time-to-reoperation. Time-to-event analysis was performed to estimate the rate of any reoperation and for THA specifically, while testing the dependency of time-to-reoperation on secondary variables. Results — 796 young femoral neck fracture patients were treated with internal fixation during the study period (median age 43 years, 39% women). Median follow-up was 8 years (IQR 4–13). One-third underwent at least 1 reoperation at a median 16 months after the index surgery (IQR 8–31). Half of reoperations were for implant removal, followed by conversion to total hip arthroplasty. 14% of the cohort were converted to THA. The median time to conversion was 2 years (IQR 1–4). Neither female sex nor older age had a statistically significant effect on time-to-reoperation or time-to-THA conversion. Interpretation — Following internal fixation of young femoral neck fracture, 1 in 3 patients required a reoperation, and 1 in 7 were converted to THA. These data should be considered by patients and surgeons during treatment decision-making.http://dx.doi.org/10.1080/17453674.2018.1558380 |
| spellingShingle | David J Stockton Lyndsay M O’Hara Nathan N O’Hara Kelly A Lefaivre Peter J O’Brien Gerard P Slobogean High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patients Acta Orthopaedica |
| title | High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patients |
| title_full | High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patients |
| title_fullStr | High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patients |
| title_full_unstemmed | High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patients |
| title_short | High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patients |
| title_sort | high rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures a population based study of 796 patients |
| url | http://dx.doi.org/10.1080/17453674.2018.1558380 |
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