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Hip hemiarthroplasty versus closed reduction percutaneous pinning: A matched cohort analysis of 18,242 patients
Anubhav Thapaliya1, Paul Gudmundsson2, Benjamin Montanez2
1University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
Background:
Closed reduction and percutaneous pinning (CRPP) and hemiarthroplasty are two common surgical treatments for hip fracture management, with different risks and benefits. This study compares short- and long-term outcomes in patients treated with CRPP versus hemiarthroplasty to emphasize the need for strategic surgical selection.
Methods:
This retrospective cohort study extracted de-identified patient data using relevant ICD-9, ICD-10, and CPT codes from the TriNetX Research Network. Two cohorts were generated: 10,179 patients receiving hemiarthroplasty and 12,436 patients receiving CRPP. Propensity score matching adjusted for age, sex, obesity status, and tobacco use, producing matched groups of 9121 patients each. Statistical significance was set at P < 0.01.
Conclusion:
CRPP patients had lower rates of transfusion, infection, and periprosthetic complications compared to hemiarthroplasty in matched cohorts. These findings highlight the need for careful surgical selection, particularly in vulnerable patients with increased risk of complications - such as patients on dialysis treatment. Further research is needed to refine patient selection criteria to optimize hip fracture outcomes and mitigate mortality risk.
