Total Hip Arthroplasty Versus Hemiarthroplasty For The Treatment Of Displaced Femoral Neck Fracture In Elderly

Abstract

SUMMARY Displaced intracapsular hip fractures are most commonly treated using either total hip arthroplasty (THA) or hemiarthroplasty. THA is a more complex procedure, takes longer, and is at higher risk of subsequent dislocation (37). However, some small randomized controlled trials (RCTs) have reported better functional outcomes, fewer wound complications, and less need for secondary procedures after THA compared to hemiarthroplasty(37; 38). In a word, HA has favor in decrease blood loss and surgery time and THA has favor in decrease the length of hospital, the incidence of pneumonia and renal failure. National guidelines therefore recommend offering THA to the fittest patients who are most likely to tolerate a bigger operation and also to benefit from better functional outcomes (42; 43), However, these recommendations have not been universally implemented. There are clear institutional challenges to widespread provision of THA, including availability of trained staff at weekends (44).