Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2010 Aug;81(4):446-52.
doi: 10.3109/17453674.2010.492763.

The cost of hemiarthroplasty compared to that of internal fixation for femoral neck fractures. 2-year results involving 222 patients based on a randomized controlled trial

Frede Frihagen  1 , Gudrun M Waaler, Jan Erik Madsen, Lars Nordsletten, Silje Aspaas, Eline Aas
Affiliations
Randomized Controlled Trial

The cost of hemiarthroplasty compared to that of internal fixation for femoral neck fractures. 2-year results involving 222 patients based on a randomized controlled trial

Frede Frihagen et al. Acta Orthop. 2010 Aug.

Abstract

Background and purpose: There is very little information on the cost of different treatments for femoral neck fractures. We assessed whether total hospital and societal costs of treatment of elderly patients with displaced femoral neck fractures differ between patients operated with internal fixation or hemiarthroplasty.

Methods: 222 patients (mean age 83 years, 165 women (74%)) who had been randomized to internal fixation or hemiarthroplasty were followed for 2 years. Resource use in hospital, rehabilitation, community-based care, and nursing home use were identified, quantified, evaluated, and analyzed.

Results: The average cost per patient for the initial hospital stay was lower for patients in the internal fixation group than in the hemiarthroplasty group (9,044 euro vs. 11,887 euro, p < 0.01). When all hospital costs, i.e. rehabilitation, reoperations, and formal and informal contact with the hospital were included, the costs were similar (21,709 euro for internal fixation vs. 19,976 euro for hemiarthroplasty). When all costs were included (hospital admissions, cost of nursing home, and community-based care), internal fixation was the most expensive treatment (47,186 euro vs. 38,615 euro (p = 0.09)).

Interpretation: The initial lower average cost per patient for internal fixation as treatment for a femoral neck fracture cannot be used as an argument in favor of this treatment, since the average cost per patient is more than outweighed by subsequent costs, mainly due to a higher reoperation rate after internal fixation.

PubMed Disclaimer

Figures

None
Flow chart of patients with hip fracture randomized to either internal fixation or hemiarthroplasty.
See this image and copyright information in PMC

References

    1. Bhandari M, Devereaux PJ, Swiontkowski MF, Tornetta P, III, Obremskey W, Koval KJ, Nork S, Sprague S, Schemitsch EH, Guyatt GH. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A meta-analysis. J Bone Joint Surg (Am) 2003;85((9)):1673–81. - PubMed
    1. Blomfeldt R, Tornkvist H, Ponzer S, Soderqvist A, Tidermark J. Comparison of internal fixation with total hip replacement for displaced femoral neck fractures. Randomized, controlled trial performed at four years. J Bone Joint Surg (Am) 2005;87((8)):1680–8. - PubMed
    1. Frihagen F, Nordsletten L, Madsen JE. Hemiarthroplasty or internal fixation for intracapsular displaced femoral neck fractures: randomised controlled trial. BMJ. 2007;335((7632)):1251–4. - PMC - PubMed
    1. Gjertsen JE, Engesaeter LB, Furnes O, Havelin LI, Steindal K, Vinje T, Fevang JM. The Norwegian Hip Fracture Register: experiences after the first 2 years and 15,576 reported operations. Acta Orthop. 2008;79((5)):583–93. - PubMed
    1. Iorio R, Healy WL, Lemos DW, Appleby D, Lucchesi CA, Saleh KJ. Displaced femoral neck fractures in the elderly: outcomes and cost effectiveness. Clin Orthop. 2001;((383)):229–42. - PubMed

Publication types