Revision Risk After Unipolar or Bipolar Hemiarthroplasty for Femoral Neck Fractures: An Instrumental Variable Analysis of 62,875 Procedures from the Australian Orthopaedic Association National Joint Replacement Registry.

The Journal of Bone and Joint Surgery. American Volume
John E FareyIan A Harris

Abstract

There remains much international practice variation regarding the choice of a unipolar or bipolar prosthesis design for displaced femoral neck fractures that are treated with hemiarthroplasty. The purpose of the present study was to compare revision rates following primary hemiarthroplasty for femoral neck fracture to determine if the unipolar hemiarthroplasty design increases the risk of revision arthroplasty for all causes. Instrumental variable analysis was performed with use of data that had been entered into the Australian Orthopaedic Association National Joint Replacement Registry from September 1, 1999, to December 31, 2018. Sixty-two thousand, eight hundred and seventy-five patients with femoral neck fractures that were treated with primary modular unipolar or bipolar hemiarthroplasty procedure were analyzed. Hospital preference for prosthesis design in the 12 months prior to the index procedure was used as an instrument to adjust for unmeasured confounding. The primary outcome was time to first revision for any cause. Secondary analyses were performed on the reason for revision (infection, dislocation, periprosthetic fracture, or acetabular erosion), the use of cement femoral stem fixation, and the type of stem (polish...Continue Reading

References

Sep 5, 2003·The Journal of Bone and Joint Surgery. American Volume·Mohit BhandariGordon H Guyatt
Sep 25, 2012·Acta Orthopaedica·Olof LeonardssonCecilia Rogmark
Feb 7, 2014·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Jan-Erik GjertsenCecilia Rogmark
Dec 6, 2014·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Bing YangXi Zhi Wen
Jun 19, 2019·EFORT Open Reviews·Claus VarnumSøren Overgaard
Nov 28, 2019·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Migliorini FilippoJörg Eschweiler
Dec 20, 2019·Clinical Orthopaedics and Related Research·Torbjørn B KristensenJan-Erik Gjertsen

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