THA for Femoral Neck Fracture — Not All It’s Cracked Up to Be

Population-level data show a lot more gray than black-and-white on a hot topic — here's how to use those data in practice

What’s the Claim?

A propensity score–matched study comparing THA to hemiarthroplasty for femoral neck fractures, which was drawn from a large regional database, found:

  • Patients treated with THA were much more likely to experience dislocation, a finding that was present at 30 days, 1 year, and 2 years
  • There were no between-group differences in revision arthroplasty (either for dislocations in the THA group early on, or, presumably, for hip pain in the hemiarthroplasty group later)

How’s It Stack Up?

We’ll try to untangle a confusing topic here. The accompanying online commentary about this article seemed to favor THA and suggested that the pendulum is swinging toward more liberal use of THA for this indication, we’re not sure we agree.