Hip-preserving surgery for nonunion about the hip

Area of Science:

• Orthopedic Surgery
• Trauma Surgery

Background:

• Hip fracture nonunions, including femoral neck, intertrochanteric, and subtrochanteric fractures, necessitate treatment decisions between hip preservation and arthroplasty.
• Hip preservation surgery aims to maintain the native hip joint, while arthroplasty involves joint replacement.

Purpose of the Study:

• To evaluate the outcomes of hip-preserving surgery for nonunions of fractures about the hip.
• To compare hip preservation outcomes with those of conversion total hip arthroplasty (cTHA).

Main Methods:

• Retrospective review of 30 patients undergoing hip preservation for hip fracture nonunion over a 10-year period.
• Functional outcomes were assessed at minimum 1-year follow-up.
• Comparison with 23 patients who underwent cTHA, analyzing length of stay, reoperation, and complication rates.

Main Results:

• Twenty-nine of thirty (96.7%) hip-preserving nonunions achieved radiographic union, with an average time to union of 6.3 months.
• Significant improvement in functional outcome scores was observed in the hip preservation group (p < 0.001).
• Reoperation rates (17%) and complication rates were comparable between hip preservation and cTHA groups.

Conclusions:

• Hip-preserving surgery is a viable treatment option for hip fracture nonunions, offering excellent radiographic union and functional results.
• The complication and reoperation rates for hip preservation are equivalent to those of conversion total hip arthroplasty.
• Consideration of hip preservation surgery is recommended for eligible patients with nonunion of fractures about the hip.