Aims For displaced femoral neck fractures (FNFs) in geriatric patients, there remains uncertainty regarding the effect of total hip arthroplasty (THA) compared with hemiarthroplasty (HA) in the guidelines. We aimed to compare 90-day surgical readmission, in-hospital complications, and charges between THA and HA in these patients. Methods The Hospital Quality Monitoring System was queried from 1 January 2013 to 31 December 2019 for displaced FNFs in geriatric patients treated with THA or HA. After propensity score matching, which identified 33,849 paired patients, outcomes were compared between THA and HA using logistic and linear regression models. Results The HA group had a lower incidence of 90-day surgical readmission than the THA group (odds ratio (OR) 0.75 (95% CI 0.68 to 0.83)). Meanwhile, the HA group had lower incidence of dislocation (OR 0.42 (95% CI 0.33 to 0.52)), aseptic loosening (OR 0.50 (95% CI 0.38 to 0.66)), and joint pain (OR 0.63 (95% CI 0.40 to 0.98)), but a higher incidence of periprosthetic fracture (OR 1.41 (95% CI 1.07 to 1.87)) for readmission, compared to the THA group. The incidence of in-hospital complications did not differ significantly between the two groups. Moreover, the HA group had lower mean charges than the THA group (47,578.29 Chinese Yuan (CNY) (SD 20,069.71) vs 57,641.00 CNY (SD 21,524.07)). Conclusion When considering 90-day surgical readmission rate, in-hospital complications, and mortality, HA resulted in a significantly lower surgical readmission rate within 90 days compared to THA, despite the patients being older and having a higher Charlson Comorbidity Index.

中文翻译：

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比较老年股骨颈骨折的手术再入院、院内并发症以及全髋关节置换术和半髋关节置换术之间的费用。


目的 对于老年患者的移位性股骨颈骨折 （FNF），与半髋关节置换术 （HA） 相比，全髋关节置换术 （THA） 的效果在指南中仍然存在不确定性。我们旨在比较这些患者的 90 天手术再入院、院内并发症以及 THA 和 HA 之间的费用。方法 2013年1月1日至2019年12月31日，查询医院质量监测系统，查找接受 THA 或 HA 治疗的老年患者移位的 FNF。在确定 33,849 名配对患者的倾向评分匹配后，使用 logistic 和线性回归模型比较 THA 和 HA 之间的结果。结果 HA 组 90 天手术再入院的发生率低于 THA 组 （比值比 （OR） 0.75 （95% CI 0.68 至 0.83））。同时，HA 组脱位发生率较低 （OR 0.42 （95% CI 0.33 至 0.52））、无菌性松动 （OR 0.50 （95% CI 0.38 至 0.66））和关节痛 （OR 0.63 （95% CI 0.40 至 0.98）），但与 THA 组相比，假体周围骨折的发生率较高 （OR 1.41 （95% CI 1.07 至 1.87））。两组之间院内并发症的发生率无显著差异。此外，HA 组的平均费用低于 THA 组（47,578.29 元人民币 （CNY） （SD 20,069.71） vs 57,641.00 元人民币 （SD 21,524.07））。结论 考虑到 90 天手术再入院率、院内并发症和死亡率，与 THA 相比，HA 导致 90 天内手术再入院率显著降低，尽管患者年龄较大且 Charlson 合并症指数较高。