![]() ![]() ![]() 22 Patients who had a femoral neck fracture in 2015 were excluded to ensure the minimum 1-year follow-up period. The eligibility criteria were: 1) a first-time admission to acute care hospitals with the diagnostic code of femoral neck fracture (International Statistical Classification of Disease and Related Health Problems, 10th Revision ICD-10, S720) 2) at least a 3-year hip fracture-free period before the enrollment to exclude bilateral femoral neck fracture patients 3) treatment with HA or THA, and 4) age between 65 and 99 at the time of the admission due to the fracture. Incident femoral neck fracture cohort and all-cause mortality The purpose of this study is to compare the mortality rate, length of hospital stay and transfusion volume between HA and THA due to femoral neck fracture in two age groups: 1) patients aged 65–79 years and 2) those aged 80–99 years. Therefore, the nationwide representative claims data used in this study reflected all of the skills and experiences of the surgeons in our country and thus, prevented selection bias. 14, 18 In addition, there are gaps in guidelines on how to treat femoral neck fractures between surgeons and institutions. Furthermore, several randomized controlled trials (RCTs) could not exclude selection bias due to small sample sizes. However, previous studies addressed the elderly patients as those older than 65 years, and there has been no study involving patients older than 80 years or comparing patients aged 80 years. 17īecause THA is associated with longer operation time and more bleeding than HA, 8 THA might lead to higher mortality compared to HA in the older elderly (> 80 years) pateints. Currently, with an increase in life expectancy, the size of population older than 80 years is growing. 16 Population aged > 65 years has been considered to be elderly. 1, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 Thus, THA has been favored more than HA and is currently in increasing use. 5Ĭomparative studies of HA and THA in the 2010s reported superior clinical results and similar mortalities after THA compared to HA in these patient cohorts. 3 Even though an earlier study reported favorable results of HA, 4 groin pain and acetabular erosion appeared as concerns after the HA. 2 Deciding which type of arthroplasty, total hip arthroplasty (THA) versus hemiarthroplasty (HA), to do in elderly femoral neck fracture patients has been a controversial issue. 1 In general, surgeons prefer internal fixation for patients aged 60 years or younger and arthroplasty for patients who are older than 65 years. Age is an important determining factor for the treatment method in femoral neck fractures. ![]()
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