OBJECTIVES: The Displaced Femoral (neck fracture) Arthroplasty Consortium for Treatment and Outcomes (DFACTO) study compared total hip arthroplasty (THA) to hemiarthroplasty in the treatment of displaced femoral neck fractures. DESIGN: This study was designed as a prospective, randomized clinical trial. SETTING: The study was conducted in five US academic and private medical centers. PATIENTS: Patients were composed of independent, mentally competent individuals, >50 years old who suffered a displaced femoral neck fracture without existing arthritis at the hip. Forty-one patients were enrolled. MAIN OUTCOME MEASURES: Functional outcomes and quality of life were assessed at 6 and 12 months post-fracture using the SF-36, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the Harris Hip Score, and the Timed "Up & Go" Test (TUG test). RESULTS: Groups were equivalent at baseline in terms of age, comorbid conditions, and functional status. At 6 months, there were no significant differences between the groups using the outcome measures or overall rates of complications. There was one dislocation in the THA group (5.8% of patients). At 12 months, the THA group reported significantly less pain (53.2 +/- 10.2) than the hemiarthroplasty group (42.4 +/- 11.5) using the SF-36 (p = 0.02). Using the TUG Test, we observed a greater proportion of THA patients remain functionally independent 1 year after surgery compared the hemiarthroplasty group (p = 0.08, controlling for age and sex). CONCLUSIONS: These differences in pain and functional outcomes suggest THA is a viable treatment option for the active elderly displaced femoral neck fracture population.
RCT Entities:
OBJECTIVES: The Displaced Femoral (neck fracture) Arthroplasty Consortium for Treatment and Outcomes (DFACTO) study compared total hip arthroplasty (THA) to hemiarthroplasty in the treatment of displaced femoral neck fractures. DESIGN: This study was designed as a prospective, randomized clinical trial. SETTING: The study was conducted in five US academic and private medical centers. PATIENTS: Patients were composed of independent, mentally competent individuals, >50 years old who suffered a displaced femoral neck fracture without existing arthritis at the hip. Forty-one patients were enrolled. MAIN OUTCOME MEASURES: Functional outcomes and quality of life were assessed at 6 and 12 months post-fracture using the SF-36, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the Harris Hip Score, and the Timed "Up & Go" Test (TUG test). RESULTS: Groups were equivalent at baseline in terms of age, comorbid conditions, and functional status. At 6 months, there were no significant differences between the groups using the outcome measures or overall rates of complications. There was one dislocation in the THA group (5.8% of patients). At 12 months, the THA group reported significantly less pain (53.2 +/- 10.2) than the hemiarthroplasty group (42.4 +/- 11.5) using the SF-36 (p = 0.02). Using the TUG Test, we observed a greater proportion of THA patients remain functionally independent 1 year after surgery compared the hemiarthroplasty group (p = 0.08, controlling for age and sex). CONCLUSIONS: These differences in pain and functional outcomes suggest THA is a viable treatment option for the active elderly displaced femoral neck fracture population.
Authors: J A Stevens; L M Hasbrouck; T M Durant; A M Dellinger; P K Batabyal; A E Crosby; B R Valluru; M Kresnow; J L Guerrero Journal: MMWR CDC Surveill Summ Date: 1999-12-17
Authors: Richard Blomfeldt; Hans Törnkvist; Sari Ponzer; Anita Söderqvist; Jan Tidermark Journal: J Bone Joint Surg Am Date: 2005-08 Impact factor: 5.284
Authors: Mohit Bhandari; P J Devereaux; Paul Tornetta; Marc F Swiontkowski; Daniel J Berry; George Haidukewych; Emil H Schemitsch; Beate P Hanson; Kenneth Koval; Douglas Dirschl; Pamela Leece; Marius Keel; Brad Petrisor; Martin Heetveld; Gordon H Guyatt Journal: J Bone Joint Surg Am Date: 2005-09 Impact factor: 5.284
Authors: Heike A Bischoff; Hannes B Stähelin; Andreas U Monsch; Maura D Iversen; Antje Weyh; Margot von Dechend; Regula Akos; Martin Conzelmann; Walter Dick; Robert Theiler Journal: Age Ageing Date: 2003-05 Impact factor: 10.668
Authors: Jay Magaziner; Lisa Fredman; William Hawkes; J Richard Hebel; Sheryl Zimmerman; Denise L Orwig; Lois Wehren Journal: Am J Epidemiol Date: 2003-06-01 Impact factor: 4.897
Authors: Frank J Raia; Cary B Chapman; Mauricio F Herrera; Michael W Schweppe; Christopher B Michelsen; Melvin P Rosenwasser Journal: Clin Orthop Relat Res Date: 2003-09 Impact factor: 4.176
Authors: Antonio De Vincentis; Astrid Ursula Behr; Giuseppe Bellelli; Marco Bravi; Anna Castaldo; Lucia Galluzzo; Giovanni Iolascon; Stefania Maggi; Emilio Martini; Alberto Momoli; Graziano Onder; Marco Paoletta; Luca Pietrogrande; Mauro Roselli; Mauro Ruggeri; Carmelinda Ruggiero; Fabio Santacaterina; Luigi Tritapepe; Amedeo Zurlo; Raffaele Antonelli Incalzi Journal: Aging Clin Exp Res Date: 2021-07-21 Impact factor: 3.636
Authors: Stephanie M Zielinski; Max A Meeuwis; Martin J Heetveld; Michiel H J Verhofstad; Gert R Roukema; Peter Patka; Esther M M Van Lieshout Journal: Int Orthop Date: 2013-04-18 Impact factor: 3.075
Authors: Paul T P W Burgers; Arnoud R Van Geene; Michel P J Van den Bekerom; Esther M M Van Lieshout; Bastiaan Blom; Ilyas S Aleem; M Bhandari; Rudolf W Poolman Journal: Int Orthop Date: 2012-05-24 Impact factor: 3.075