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. 2015 Sep;6(3):168-72.
doi: 10.1177/2151458515583111.

Who Will Walk Again? Effects of Rehabilitation on the Ambulatory Status in Elderly Patients Undergoing Hemiarthroplasty for Femoral Neck Fracture

Junren Zhang  1 , Mu Liang Ang  1 , Ernest Beng Kee Kwek  1
Affiliations

Who Will Walk Again? Effects of Rehabilitation on the Ambulatory Status in Elderly Patients Undergoing Hemiarthroplasty for Femoral Neck Fracture

Junren Zhang et al. Geriatr Orthop Surg Rehabil. 2015 Sep.

Abstract

Introduction: Femoral neck fractures in elderly patients result in significant reduction in mobility. Deconditioning takes place quickly without early ambulation postsurgery. A recent Cochrane review found inconclusive evidence on the rehabilitation protocol required to effectively restore patients' prefracture mobility status. This study was conducted to determine the effects of different rehabilitation approaches on the functional and mobility outcomes of elderly patients after hip hemiarthroplasty for femoral neck fractures.

Materials and methods: We enrolled consecutive patients aged >65 years, admitted into a tertiary orthopedic unit from January to December 2010, who had undergone hip hemiarthroplasty. They were divided into 3 cohorts: (a) home with outpatient rehabilitation, (b) intensive short rehabilitation, and (c) extended slow-stream rehabilitation. Clinical variables were collected along with outcome variables of Modified Harris Hip Score, Parker Mobility Score (PMS), and the return to near premorbid ambulatory status at 1 year (PMS decrease of ≤2).

Results: A total of 133 patients were recruited and followed up for a year. The 3 cohorts were found to be comparable for prefall cardiovascular diseases, PMS, and Katz Index, although it was found that in the slow-stream cohort, there was a greater percentage of patients with previous cerebrovascular accidents. Patients in the intensive short rehabilitation cohort were found to have a higher proportion of patients returning to prefracture mobility, with the odds ratio of 2.3478 (95% confidence interval: 1.0667 to 5.1674; P = .042) after multivariate analysis.

Conclusions: Elderly patients >65 years who had undergone hemiarthroplasty would likely benefit most from an intensive inpatient rehabilitation program.

Keywords: ambulatory status; fragility hip fractures; hemiarthroplasty; osteoporosis; rehabilitation.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Radiographs of a Patient with Femoral Neck Fracture treated with Hemiarthroplasty.
Figure 2.
Figure 2.
Protocol of selection criteria for rehabilitation program.
See this image and copyright information in PMC

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