"Outcomes of Fractured Neck of Femur Managed with Arthroplasty at Flinders Medical Centre: A Breakdown of Demographics using Early Results of a Local Revision Registry"

Abstract

Trauma comprises a significant proportion of hip surgery at our local hospital, Flinders Medical Centre (FMC). With regards to neck of femur fractures (#NOF), many cases are managed with an internal fixation approach rather than arthroplasty. National data suggest that hip arthroplasties (THAs) are increasingly being used in preference for hemiarthroplasties (HAs) for intra-capsular #NOF to improve patients function post-op. The aim of this retrospective cohort study was to continue building a robust prospective local Revision Registry in order to continue evaluate trends in local data regarding the aetiology and rates of revision hip arthroplasties at Flinders Medical Centre, where the primary arthroplasty was undertaken secondary to trauma. Data was compiled from our own documented records cross-matched with national records. Patients were included if their primary surgery was a HA or THA in the setting of #NOF, who had revision surgeries that were performed within FMC during the time period of 2016-2019. Data were evaluated descriptively with basic quantitative analyses. 455 post-traumatic arthroplasty surgeries were performed within the time frame, 78.9% of which has at our centre. Of 359 HAs performed, five were revised; of 96 THAs performed, two were revised. Revision of THAs occurred earlier, with an average of 2.17 years compared to 2.62 years. Revision of THAs occurred in younger patients, with average age at revision of THAs of 62 compared to 85.5 years. Revision of hemiarthroplasties was mostly performed due to instability of prosthetic components and patient factors, whilst revisions of THAs may have been related to surgical error. Revision of THAs seems less frequent and more related to surgical error and affects younger patients. The development of a specialised Arthroplasty service for THA in trauma may lead to an increased use of THA which is common in other centres and reduce surgical errors. Long term follow-up in the form of a local registry is ongoing and early data shows it to be a beneficial resource to guide local future management principles.