TY - JOUR
T1 - Comparison Between Orthopaedic Trauma Versus Arthroplasty Fellowship Training on Outcomes of Total Hip Arthroplasty for Femoral Neck Fracture
AU - The Arthroplasty for Hip Fracture Consortium
AU - Cao, Amanda
AU - Ghanem, Elie S.
AU - Cichos, Kyle H.
AU - Lichstein, Paul
AU - Patel, Stuti
AU - Jordan, Eric
AU - Sing, David
AU - Frandsen, Jeff
AU - DeKeyser, Graham
AU - Blackburn, Brenna
AU - Sauer, Madeline A.
AU - Ewing, Michael
AU - Hansen, Erik N.
AU - Gililland, Jeremy M.
AU - O'Malley, Michael
AU - McGwin, Gerald
AU - Mueller, Joshua M.
AU - Mears, Simon C.
AU - Bhanat, Eldrin
AU - Stayer, George W.
AU - Almand, Mariegene E.
AU - Bergin, Patrick F.
AU - Yener, Ugur
AU - Stayer, George
AU - Stambough, Jeffrey B.
AU - Stronach, Benjamin M.
AU - Crist, Brett
AU - Keeney, James A.
AU - Melnic, Christopher M.
AU - Boyd, Brandon
AU - Chen, Antonia F.
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/7
Y1 - 2023/7
N2 - Background: This study aimed to identify differences in patient characteristics, perioperative management methods, and outcomes for total hip arthroplasty (THA) for femoral neck fracture (FNF) when performed by orthopaedic surgeons who have arthroplasty versus orthopaedic trauma training. Methods: This study was a multicenter retrospective review of 636 patients who underwent THA for FNF between 2010 and 2019. There were 373 patients who underwent THA by an arthroplasty surgeon, and 263 who underwent THA by an orthopaedic trauma surgeon. Comorbidities, management methods, and outcomes were compared between patients operated on by orthopaedic surgeons who had arthroplasty versus trauma training. Results: Arthroplasty-trained surgeons had shorter operative times (102 versus 128 minutes, P < .0001) and utilized tranexamic acid more frequently than trauma-trained surgeons (48.8 versus 18.6%, P < .0001). Orthopaedic trauma surgeons more frequently utilized an anterior approach. Patients of arthroplasty-trained surgeons had lower rates of complications including pulmonary embolism (1.6 versus 6.5%, P = .0019) and myocardial infarction (1.6 versus 11.0%, P < .0001). Similarly, patients of arthroplasty-trained surgeons were discharged faster (5.3 versus 7.9 days, P < .0001) with greater ambulation capacity (92.2 versus 57.2 feet, P < .0001). Dislocation, periprosthetic joint infection, and revision were similar between both groups. When adjusted for covariates, there was no difference in 90-day, 1-year, or 2-year mortality. Conclusion: A THA performed for FNF by arthroplasty surgeons was associated with lower in-hospital morbidities and improved functional statuses at discharge. However, mortalities and complications after discharge were similar between both specialties when adjusted for confounding variables. Optimization of protocols may further improve outcomes for THA for FNF.
AB - Background: This study aimed to identify differences in patient characteristics, perioperative management methods, and outcomes for total hip arthroplasty (THA) for femoral neck fracture (FNF) when performed by orthopaedic surgeons who have arthroplasty versus orthopaedic trauma training. Methods: This study was a multicenter retrospective review of 636 patients who underwent THA for FNF between 2010 and 2019. There were 373 patients who underwent THA by an arthroplasty surgeon, and 263 who underwent THA by an orthopaedic trauma surgeon. Comorbidities, management methods, and outcomes were compared between patients operated on by orthopaedic surgeons who had arthroplasty versus trauma training. Results: Arthroplasty-trained surgeons had shorter operative times (102 versus 128 minutes, P < .0001) and utilized tranexamic acid more frequently than trauma-trained surgeons (48.8 versus 18.6%, P < .0001). Orthopaedic trauma surgeons more frequently utilized an anterior approach. Patients of arthroplasty-trained surgeons had lower rates of complications including pulmonary embolism (1.6 versus 6.5%, P = .0019) and myocardial infarction (1.6 versus 11.0%, P < .0001). Similarly, patients of arthroplasty-trained surgeons were discharged faster (5.3 versus 7.9 days, P < .0001) with greater ambulation capacity (92.2 versus 57.2 feet, P < .0001). Dislocation, periprosthetic joint infection, and revision were similar between both groups. When adjusted for covariates, there was no difference in 90-day, 1-year, or 2-year mortality. Conclusion: A THA performed for FNF by arthroplasty surgeons was associated with lower in-hospital morbidities and improved functional statuses at discharge. However, mortalities and complications after discharge were similar between both specialties when adjusted for confounding variables. Optimization of protocols may further improve outcomes for THA for FNF.
KW - fellowship
KW - femoral neck fracture
KW - outcomes
KW - surgeon training
KW - total hip arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85158901855&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85158901855&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2023.04.009
DO - 10.1016/j.arth.2023.04.009
M3 - Article
C2 - 37068569
AN - SCOPUS:85158901855
SN - 0883-5403
VL - 38
SP - S72-S77
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 7
ER -