TY - JOUR
T1 - Functional outcome after successful internal fixation versus salvage arthroplasty of patients with a femoral neck fracture
AU - The FAITH Investigators
AU - Zielinski, Stephanie M.
AU - Keijsers, Noël L.
AU - Praet, Stephan F.E.
AU - Heetveld, Martin J.
AU - Bhandari, Mohit
AU - Wilssens, Jean Pierre
AU - Patka, Peter
AU - Anderson, Sarah A
AU - Van Lieshout, Esther M.M.
N1 - Publisher Copyright:
© 2014 Lippincott Williams & Wilkins.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2014/12/11
Y1 - 2014/12/11
N2 - Objectives: To determine patient independency, health-related and disease-specific quality of life (QOL), gait pattern, and muscle strength in patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture.Design: Secondary cohort study to a randomized controlled trial.\r\nSetting: Multicenter trial in the Netherlands, including 14 academic and nonacademic hospitals.\r\nPatients: Patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture were studied. A comparison was made with patients who healed uneventfully after internal fixation. Intervention: None (observatory study). Main Outcome Measurements: Patient characteristics, SF-12, and Western Ontario McMaster osteoarthritis index scores were collected. Gait parameters were measured using plantar pressure measurement. Maximum isometric forces of the hip muscles were measured using a handheld dynamometer. Differences between the fractured and contralateral leg were calculated. Groups were compared using univariate analysis.\r\nResults: Of 248 internal fixation patients (median age, 72 years), salvage arthroplasty was performed in 68 patients (27%). Salvage arthroplasty patients had a significantly lower Western Ontario McMaster osteoarthritis index score (median, 73 vs. 90; P = 0.016) than patients who healed uneventfully after internal fixation. Health-related QOL (SF-12) and patient independency did not differ significantly between the groups. Gait analysis showed a significantly impaired progression of the center of pressure in the salvage surgery patients (median ratio, 28.9 vs. 0.4, P = 0.013) and a significant greater loss of abduction strength (median, 225.4 vs. 220.4 N, P = 0.025).\r\nConclusions: Despite a similar level of dependency and QOL, salvage arthroplasty patients have inferior functional outcome than patients who heal after internal fixation of a femoral neck fracture.
AB - Objectives: To determine patient independency, health-related and disease-specific quality of life (QOL), gait pattern, and muscle strength in patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture.Design: Secondary cohort study to a randomized controlled trial.\r\nSetting: Multicenter trial in the Netherlands, including 14 academic and nonacademic hospitals.\r\nPatients: Patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture were studied. A comparison was made with patients who healed uneventfully after internal fixation. Intervention: None (observatory study). Main Outcome Measurements: Patient characteristics, SF-12, and Western Ontario McMaster osteoarthritis index scores were collected. Gait parameters were measured using plantar pressure measurement. Maximum isometric forces of the hip muscles were measured using a handheld dynamometer. Differences between the fractured and contralateral leg were calculated. Groups were compared using univariate analysis.\r\nResults: Of 248 internal fixation patients (median age, 72 years), salvage arthroplasty was performed in 68 patients (27%). Salvage arthroplasty patients had a significantly lower Western Ontario McMaster osteoarthritis index score (median, 73 vs. 90; P = 0.016) than patients who healed uneventfully after internal fixation. Health-related QOL (SF-12) and patient independency did not differ significantly between the groups. Gait analysis showed a significantly impaired progression of the center of pressure in the salvage surgery patients (median ratio, 28.9 vs. 0.4, P = 0.013) and a significant greater loss of abduction strength (median, 225.4 vs. 220.4 N, P = 0.025).\r\nConclusions: Despite a similar level of dependency and QOL, salvage arthroplasty patients have inferior functional outcome than patients who heal after internal fixation of a femoral neck fracture.
KW - Femoral neck fracture
KW - Functional outcome
KW - Hip fracture
KW - Internal fixation
KW - Salvage arthroplasty
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U2 - 10.1097/BOT.0000000000000123
DO - 10.1097/BOT.0000000000000123
M3 - Article
C2 - 24835623
AN - SCOPUS:84917672898
VL - 28
SP - e273-e280
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
SN - 0890-5339
IS - 12
ER -