Comparison of complication rates between hemiarthroplasty and total hip arthroplasty for intracapsular hip fractures.

Hip fractures are common and have come to represent an increasing burden of disease. As a result, it is critical that cost-effective and evidence-based treatments be used to treat hip fractures. However, with regard to hemiarthroplasty vs total hip arthroplasty (THA), the optimal treatment of displaced femoral neck fractures in elderly patients remains controversial. The purpose of this study was to compare complication rates after hemiarthroplasty and THA for intracapsular hip fractures.Data on hospitalizations from 1995 through 2005 were obtained from California's Office of Statewide Health Planning and Development. Regression analyses were used to compare rates of short-term complications and mid-term revision surgeries following hemiarthroplasty and THA. The data identified 2437 patients undergoing THA and 38,328 undergoing hemiarthroplasty. At 90 days postoperatively, patients undergoing THA had no statistically significant increase in short-term complication risk compared with patients undergoing hemiarthroplasty (odds ratio, 0.89; P=.06). Cox regression analysis demonstrated no statistically significant difference in risk of revision surgery during the 11-year observation period.This study demonstrates similar short-term complication and mid-term revision risks following hemiarthroplasty and THA. This suggests that both procedures are safe alternatives, but further study is needed to clarify differences in functional outcomes and long-term revision rates for patients undergoing these procedures following a hip fracture.