Functional outcome after successful internal fixation versus salvage arthroplasty of patients with a femoral neck fracture

The FAITH Investigators, Stephanie M. Zielinski, Noël L. Keijsers, Stephan F.E. Praet, Martin J. Heetveld, Mohit Bhandari, Jean Pierre Wilssens, Peter Patka, Sarah A Anderson, Esther M.M. Van Lieshout

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

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\n

Setting: Multicenter trial in the Netherlands, including 14 academic and nonacademic hospitals.\r\n

Patients: 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\n

Results: 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\n

Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)e273-e280
JournalJournal of orthopaedic trauma
Volume28
Issue number12
DOIs
StatePublished - Dec 11 2014

Bibliographical note

Publisher Copyright:
© 2014 Lippincott Williams & Wilkins.

Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.

Keywords

  • Femoral neck fracture
  • Functional outcome
  • Hip fracture
  • Internal fixation
  • Salvage arthroplasty

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