PT  - JOURNAL ARTICLE
AU  - Taranjit Tung
AU  - Trevor C. Gascoyne
AU  - Elly Trepman
AU  - Carole H. Stipelman
AU  - Sarah Tran
AU  - Eric R. Bohm
AU  - Colin D. Burnell
AU  - David R. Hedden
AU  - Thomas R. Turgeon
TI  - Modes of failure of hip hemiarthroplasty for femoral neck fracture
AID  - 10.1503/cjs.006821
DP  - 2022 Aug 12
TA  - Canadian Journal of Surgery
PG  - E519--E526
VI  - 65
IP  - 4
4099  - http://canjsurg.ca/content/65/4/E519.short
4100  - http://canjsurg.ca/content/65/4/E519.full
SO  - CAN J SURG2022 Aug 12; 65
AB  - Background: Hemiarthroplasty is a common treatment for displaced femoral neck fractures, but limited Canadian data are available about hemiarthroplasty failure. We evaluated the frequency and predictors of hemiarthroplasty failure in Manitoba.Methods: In this retrospective multicentre province-wide study, billing and joint registry databases showed 4693 patients who had hemiarthroplasty for treatment of femoral neck fracture in Manitoba over an 11-year period (2005–2015), including 155 hips with subsequent reoperations (open or closed) for treatment of hemiarthroplasty failure. Hospital records were reviewed to identify modes of hemiarthroplasty failure, comorbidities and reoperations. Data were analyzed using χ2 test and Poisson and γ regression models.Results: During our study period, 155 hips (154 patients [3%]) underwent 230 reoperations. Of these, 131 hips (85%) initially had an uncemented unipolar modular implant. Indications for first-time reoperation included periprosthetic femur fracture (49 hips [32%]), dislocation (45 hips [29%]), acetabular wear (28 hips [18%]) and infection (26 hips [17%]). There were 46 hips (30%) that had 2 or more reoperations. Reoperation for dislocation was associated with presence of dementia; acetabular wear was associated with absence of dementia. Time from hemiarthroplasty to reoperation was associated inversely with age at hemiarthroplasty, dislocation and dementia and was directly associated with acetabular wear. The risk of having 2 or more reoperations was associated independently with dislocation, infection, and alcohol abuse.Conclusion: Hemiarthroplasty for femoral neck fracture in Manitoba had a low frequency of failure. Risk factors for multiple reoperations included dislocation, infection and alcohol abuse.