Total Hip Arthroplasty is Increasing in Utilization for Femoral Neck Fractures

Objectives Femoral neck fractures (FNFx) commonly present in older adults and typically require surgical intervention. Different surgical techniques may be used to treat FNFx, including hip fracture repair with pinning, hemi-hip arthroplasty (HHA), and total hip arthroplasty (THA). Traditionally, hemiarthroplasty has been the most common treatment for displaced FNFx. However, there has been a trend toward treating displaced FNFx with THA. This study was undertaken to identify trends in the treatments for FNFx. The study hypothesis was that THA use for the treatment of FNFx increased over time. Methods The TriNetX US Collaborative Network database was queried for patients treated with surgical management of FNFx from 2017 to 2022. Cohorts were defined using International Classification Of Diseases, Tenth Revision (ICD-10) and Current Procedural Terminology (CPT) codes to include patients aged>65 years with FNFx and one of the three operations. Patients were divided into groups: HHA, THA, and pinning. Cohorts were compared, and bivariate analyses were performed to identify significant differences between groups. Results Over the study period, the gender distribution remained stable overall. When patients were broken down by operative technique, 15% underwent pinning, 16% underwent THA, and 69% underwent HHA. However, the THA rate showed a small but statistically significant increase over the study period (P<0.001), from 14% in 2017 to 17% by 2022. Conclusion HHA remains the most common treatment modality for FNFx. The study hypothesis was upheld with the utilization of THA for FNFx increasing over time.