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J Am Acad Orthop Surg, Vol 14, No 5, May 2006, 287-293.
© 2006 the American Academy of Orthopaedic Surgeons
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Displaced Femoral Neck Fractures in the Elderly: Hemiarthroplasty Versus Total Hip Arthroplasty

William Macaulay, MD, Michael R. Pagnotto, MD, Richard Iorio, MD, Michael A. Mont, MD and Khaled J. Saleh, MD, Msc, FRCSC

Dr. Macaulay is Director, Center of Hip and Knee Replacement, and Associate Professor of Orthopaedic Surgery, Columbia University, New York, NY. Dr. Pagnotto is Resident, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA. Dr. Iorio is Senior Attending Orthopaedic Surgeon, Lahey Clinic, Burlington, MA. Dr. Mont is Director, Center for Joint Preservation and Reconstruction, Rubin Institute for Advanced Orthopaedics, Sinai Hospital of Baltimore, Baltimore, MD. Dr. Saleh is Associate Professor, Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Macaulay, Dr. Pagnotto, Dr. Iorio, and Dr. Mont. Dr. Saleh or the department with which he is affiliated has received research or institutional support from Smith & Nephew and Stryker. Dr. Saleh or the department with which he is affiliated has received royalties from Smith & Nephew. Dr. Saleh or the department with which he is affiliated serves as a consultant to or is an employee of Smith & Nephew and Stryker.

Reprint requests: Dr. Macaulay, Department of Orthopaedic Surgery, Columbia University, PH-1155, 622 W 168th Street, New York, NY 10032.

The incidence of femoral neck fracture among the elderly in the United States is expected to increase dramatically because of the anticipated explosion in the population aged 65 years and older, increased life expectancy, and the rising incidence of osteoporosis. The resulting public health implications may be significant, with annual hospital admissions resulting from hip fracture projected to increase to 700,000 by 2050, and with annual spending on hip fracture care expected to exceed $15 billion within a few years. The decision to perform internal fixation, unipolar hemiarthroplasty, bipolar hemiarthroplasty, or THA must be based on patient mental status, living arrangement, level of independence and activity, and bone and joint quality.




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