%0 Journal Article
%T High rate of reoperation and conversion to total hip arthroplasty after internal fixation of young femoral neck fractures: a population-based study of 796 patients
%A David J Stockton
%A Gerard P Slobogean
%A Kelly A Lefaivre
%A Lyndsay M O¡¯Hara
%A Nathan N O¡¯Hara
%A Peter J O¡¯Brien
%J Acta Orthopaedica
%D 2019
%R https://doi.org/10.1080/17453674.2018.1558380
%X Background and purpose ¡ª Most often, the goal of non-geriatric femoral neck fracture surgery is to preserve the native hip joint. However, reoperations for painful implants, osteonecrosis, and nonunion are common. We determined the reoperation rate and time-to-reoperation following internal fixation of these fractures in a large population cohort. Patients and methods ¡ª This retrospective cohort study included patients between the ages of 18 and 50 years old who underwent internal fixation for a femoral neck fracture during 1997¨C2013. Patients were followed until December 2013. Primary outcomes were reoperation rate and time-to-reoperation. Time-to-event analysis was performed to estimate the rate of any reoperation and for THA specifically, while testing the dependency of time-to-reoperation on secondary variables. Results ¡ª 796 young femoral neck fracture patients were treated with internal fixation during the study period (median age 43 years, 39% women). Median follow-up was 8 years (IQR 4¨C13). One-third underwent at least 1 reoperation at a median 16 months after the index surgery (IQR 8¨C31). Half of reoperations were for implant removal, followed by conversion to total hip arthroplasty. 14% of the cohort were converted to THA. The median time to conversion was 2 years (IQR 1¨C4). Neither female sex nor older age had a statistically significant effect on time-to-reoperation or time-to-THA conversion. Interpretation ¡ª Following internal fixation of young femoral neck fracture, 1 in 3 patients required a reoperation, and 1 in 7 were converted to THA. These data should be considered by patients and surgeons during treatment decision-making
%U https://www.tandfonline.com/doi/full/10.1080/17453674.2018.1558380