Total Hip Arthroplasty for Hip Fracture: Clinical Results and Mid-Term Survivorship

Aim The purpose of this study is to report the clinical results and mid-term survivorship for total hip arthroplasty (THA) performed to treat displaced intracapsular hip fracture. Methods Between January 2005 and December 2019, 414 patients underwent THA for acute displaced intracapsular hip fracture. The mean age of patients was 73.2±8.0. Out of the total patients, 89.6% received a cemented THA. Kaplan-Meier analysis was performed with implant survivorship and dislocation as separate endpoints. Complications and modified Harris Hip Score (HHS) at the latest follow-up were also reported. Results There was a total of nine revisions, six were performed for dislocation and three for infection. Kaplan-Meier implant survivorship was 99.0% at five years and 97.7% at ten years. Twenty (4.8%) patients suffered at least one dislocation and 11 suffered more than one, so following a first dislocation, the chance of one or more further dislocations was 11/20 (55%). Kaplan-Meier analysis with dislocation as the endpoint showed the risk of dislocation of 2.9, 4.4, and 5.2% at one, five, and ten years respectively. Three (0.7%) patients suffered late periprosthetic fractures and 22 (5.3%) contralateral hip fractures. The mean modified HHS at the latest follow-up was 86.3±18.9. Conclusion In conclusion, the present study shows excellent implant survivorship, good hip function, and moderate risk of dislocation and contralateral hip fracture following THA for displaced intracapsular hip fracture. Our study shows favourable results for THA treatment in a selected group of patients with hip fractures.