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
. 2024 Mar 1;110(3):1347-1355.
doi: 10.1097/JS9.0000000000000794.

Trends and benefits of early hip arthroplasty for femoral neck fracture in China: a national cohort study

Yuqing Wang  1 , Qiao Jiang  1 , Huizhong Long  1 , Hu Chen  2 , Jie Wei  3   4   5   6 , Xiaoxiao Li  3   6 , Haibo Wang  7   8 , Dongxing Xie  1 , Chao Zeng  1   9   3   6 , Guanghua Lei  1   9   3   6
Affiliations

Trends and benefits of early hip arthroplasty for femoral neck fracture in China: a national cohort study

Yuqing Wang et al. Int J Surg. .

Abstract

Background: Limited studies have examined the benefits of early arthroplasty within 48 h from admission to surgery for femoral neck fractures (FNFs). Using the national inpatient database, the authors aimed to investigate the trends in early arthroplasty within 48 h for FNFs in China and to assess its effect on in-hospital complications and 30-day readmission patterns.

Materials and methods: This was a retrospective cohort study. Patients receiving primary total hip arthroplasty (THA) or hemiarthroplasty (HA) for FNFs in the Hospital Quality Monitoring System between 2013 and 2019 were included. After adjusting for potential confounders with propensity score matching, a logistic regression model was performed to compare the differences in in-hospital complications [i.e. in-hospital death, pulmonary embolism, deep vein thrombosis (DVT), wound infection, and blood transfusion], rates and causes of 30-day readmission between early and delayed arthroplasty.

Results: During the study period, the rate of early THA increased from 18.0 to 19.9%, and the rate of early HA increased from 14.7 to 18.4% ( P <0.001). After matching, 11 731 pairs receiving THA and 13 568 pairs receiving HA were included. Compared with delayed THA, early THA was associated with a lower risk of pulmonary embolism [odds ratio (OR) 0.51, 95% CI: 0.30-0.88], DVT (OR 0.59, 95% CI: 0.50-0.70), blood transfusion (OR 0.62, 95% CI: 0.55-0.70), 30-day readmission (OR 0.82, 95% CI: 0.70-0.95), and venous thromboembolism-related readmission (OR 0.50, 95% CI: 0.34-0.74). Similarly, early HA was associated with a lower risk of DVT (OR 0.70, 95% CI: 0.61-0.80) and blood transfusion (OR 0.74, 95% CI: 0.68-0.81) than delayed HA.

Conclusion: Despite a slight increase, the rate of early arthroplasty remained at a low level in China. Given that early arthroplasty can significantly improve prognosis, more efforts are needed to optimize the procedure and shorten the time to surgery.

Trial registration: ClinicalTrials.gov NCT05170321.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Flowchart of analysis.
Figure 2
Figure 2
Trends in the proportion of early arthroplasty within 48 h from 2013 to 2019.
See this image and copyright information in PMC

References

    1. Thevenot J, Hirvasniemi J, Pulkkinen P, et al. Assessment of risk of femoral neck fracture with radiographic texture parameters: a retrospective study. Radiology 2014;272:184–191. - PubMed
    1. Huang S, Wang B, Zhang X, et al. High-purity weight-bearing magnesium screw: translational application in the healing of femoral neck fracture. Biomaterials 2020;238:119829. - PubMed
    1. Brox WT, Roberts KC, Taksali S, et al. The American Academy of Orthopaedic surgeons evidence-based guideline on management of hip fractures in the elderly. J Bone Joint Surg Am 2015;97:1196–1199. - PMC - PubMed
    1. Bhandari M Einhorn TA Guyatt G et al. HEALTH Investigators . Total hip arthroplasty or hemiarthroplasty for hip fracture. N Engl J Med 2019;381:2199–2208. - PubMed
    1. Chang W, Lv H, Feng C, et al. Preventable risk factors of mortality after hip fracture surgery: systematic review and meta-analysis. Int J Surg 2018;52:320–328. - PubMed

Associated data