ArticleJB & JS open access
HOPE Trial: Hemiarthroplasty Compared with Total Hip Arthroplasty for Displaced Femoral Neck Fractures in Octogenarians: A 4- and 10-Year Follow-Up of a Randomized Controlled Trial.
Article in JB & JS open access. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The optimal use of primary hemiarthroplasty (HA) or total hip arthroplasty (THA) for treating displaced femoral neck fractures (FNFs) remains controversial. This study aims to compare the outcomes of HA and THA in ambulatory patients 80 years or older, at 4- and 10-year postsurgery. Methods: In a prospective, randomized, single-blind trial, patients with acute displaced FNFs with a mean age of 85 (range 80-94) years were randomly allocated to receive either HA or THA. The primary end points were hip function (Harris Hip Score, HHS) and health-related quality of life (European Quality of Life-5 Dimensions [EQ-5D]). Secondary end points included hip-related complications, reoperations, mortality, pain in the affected hip, activities of daily living, a radiographic evaluation of acetabular erosion, and general complications. Results: At the 4-year follow-up, 39 patients in the HA and 39 in the THA group were available. At 10 years, 10 HA patients and 16 THA patients were available for follow-up. No differences were observed in the HHS at 4 and 10 years. The EQ-5D Index was statistically significant in favor of THA at 4 years, but no difference was observed at 10 years. No differences were found between the groups regarding hip-related complications, reoperations, mortality, activities of daily living, and pain in the operated hip. Hip function, activities of daily living, and pain in the operated hip deteriorated over time. Conclusion: Up to 10 years after surgery, both HA and THA demonstrated comparable outcomes in hip function and health-related quality of life in ambulatory octogenarians and nonagenarians with displaced FNFs. This suggests that both interventions are suitable for this group of older patients. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Registered trials
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