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Scientific Articles   |    
Comparison of Bipolar Hemiarthroplasty with Total Hip Arthroplasty for Displaced Femoral Neck FracturesA Concise Four-Year Follow-up of a Randomized Trial*
Carl Johan Hedbeck, MD1; Anders Enocson, MD, PhD1; Gunilla Lapidus, MD2; Richard Blomfeldt, MD, PhD1; Hans Törnkvist, MD, PhD1; Sari Ponzer, MD, PhD1; Jan Tidermark, MD, PhD1
1 Karolinska Institutet, Department of Clinical Science and Education, Section of Orthopaedics, Södersjukhuset, 118 83 Stockholm, Sweden. E-mail address for C.J. Hedbeck: carl-johan.hedbeck@sodersjukhuset.se. E-mail address for A. Enocson: anders.enocson@sodersjukhuset.se. E-mail address for R. Blomfeldt: richard.blomfeldt@sodersjukhuset.se. E-mail address for H. Törnkvist: hans.tornqvist@sodersjukhuset.se. E-mail address for S. Ponzer: sari.ponzer@ki.se. E-mail address for J. Tidermark: jan.tidermark@capio.se
2 Unilabs St Göran Radiology, Capio St Göran's Hospital, 112 81 Stockholm, Sweden. E-mail address: gunilla.lapidus@unilabs.com
View Disclosures and Other Information
Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the Trygg-Hansa Insurance Company and the Stockholm County Council. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Classification: Adult Hip; Taruma
Original Publication Blomfeldt R, Törnkvist H, Eriksson K, Söderqvist A, Ponzer S, Tidermark J. A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. J Bone Joint Surg Br. 2007;89:160-5.
Investigation performed at the Department of Orthopaedics, Södersjukhuset, Stockholm, Sweden

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Mar 02;93(5):445-450. doi: 10.2106/JBJS.J.00474
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Abstract

Abstract: 

We performed a four-year follow-up of a randomized controlled trial involving 120 elderly patients with an acute displaced femoral neck fracture who were randomized to treatment with either a bipolar hemiarthroplasty or a total hip arthroplasty. The difference in hip function (as indicated by the Harris hip score) in favor of the total hip arthroplasty group that was previously reported at one year persisted and seemed to increase with time (mean score, 87 compared with 78 at twenty-four months [p < 0.001] and 89 compared with 75 at forty-eight months [p < 0.001]). The health-related quality of life (as indicated by the EuroQol [EQ-5Dindex] score) was better in the total hip arthroplasty group at the time of each follow-up, but the difference was significant only at forty-eight months (p < 0.039). These results confirm the better results in terms of hip function and quality of life after total hip arthroplasty as compared with hemiarthroplasty in elderly, lucid patients with a displaced fracture of the femoral neck.

Level of Evidence: 

Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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