Abstract
Objectives: To determine patient independency, health-related and disease-specific quality of life (QOL), gait pattern, and muscle strength in patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture. Design: Secondary cohort study to a randomized controlled trial. Setting: Multicenter trial in the Netherlands, including 14 academic and nonacademic hospitals. Patients: Patients after salvage arthroplasty for failed internal fixation of a femoral neck fracture were studied. A comparison was made with patients who healed uneventfully after internal fixation. Intervention: None (observatory study). Main Outcome Measurements: Patient characteristics, SF-12, and Western Ontario McMaster osteoarthritis index scores were collected. Gait parameters were measured using plantar pressure measurement. Maximum isometric forces of the hip muscles were measured using a handheld dynamometer. Differences between the fractured and contralateral leg were calculated. Groups were compared using univariate analysis. Results: Of 248 internal fixation patients (median age, 72 years), salvage arthroplasty was performed in 68 patients (27%). Salvage arthroplasty patients had a significantly lower Western Ontario McMaster osteoarthritis index score (median, 73 vs. 90; P = 0.016) than patients who healed uneventfully after internal fixation. Health-related QOL (SF-12) and patient independency did not differ significantly between the groups. Gait analysis showed a significantly impaired progression of the center of pressure in the salvage surgery patients (median ratio, 28.9 vs. 0.4, P = 0.013) and a significant greater loss of abduction strength (median, 225.4 vs. 220.4 N, P = 0.025). Conclusions: Despite a similar level of dependency and QOL, salvage arthroplasty patients have inferior functional outcome than patients who heal after internal fixation of a femoral neck fracture.
Original language | Undefined/Unknown |
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Pages (from-to) | E273-E280 |
Journal | Journal of Orthopaedic Trauma |
Volume | 28 |
Issue number | 12 |
DOIs | |
Publication status | Published - 2014 |
Bibliographical note
FAITH trial study group Authors see ACKNOWLEDGMENTSResearch programs
- EMC MUSC-01-46-01
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