Evidence-Based Orthopaedics   |    
Hans J. Kreder, MD, MPH, FRCS(C)
View Disclosures and Other Information
Sunnybrook and Women's College Health, Sciences Centre, Toronto, Ontario, Canada

J Bone Joint Surg Am, 2002 Nov 01;84(11):2108-a-2108
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


Little debate surrounds the treatment of displaced fractures of the femoral neck in very young, high-demand patients (generally treated with fixation) and very old, low-demand patients (generally treated with arthroplasty). However, defining the boundaries for these extremes and the treatment for patients in the middle is controversial. The study by Rogmark et al. used an age of =70 years as a surrogate for bone quality and demand, with no upper age limit. In order to recruit a sufficient number of patients, a multicenter study was required; however, no attempt was made to standardize surgical technique or choice of implant. Moreover, after random allocation to "arthroplasty," this group was further subdivided to receive either total hip replacement or hemiarthroplasty on the rather arbitrary basis of patient age, mental status, and life situation. Surgeons from 12 hospitals implanted 2 types of pins and more than 10 different types of arthroplasty components (using the operative approach of their choice). Details regarding quality of reduction, type of anesthetic, and prophylaxis against deep-vein thrombosis were not provided.
Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    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.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    IL - Hinsdale Orthopaedics
    OR - The Center - Orthopedic and Neurosurgical Care and Research
    NY - Icahn School of Medicine at Mount Sinai
    GA - Choice Care Occupational Medicine & Orthopaedics