Mortality Rate and Charlson Co-morbidity Scores of Patients with Femoral Neck Fractures Treated with Hip Hemiarthroplasty using Austin-Moore, Thompson, and Modular Hip Prostheses in a Tertiary Government Hospital

Mortality Rate and Charlson Co-morbidity Scores of Patients with Femoral Neck Fractures Treated with Hip Hemiarthroplasty using Austin-Moore, Thompson, and Modular Hip Prostheses in a Tertiary Government Hospital | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Mortality Rate and Charlson Co-morbidity Scores of Patients with Femoral Neck Fractures Treated with Hip Hemiarthroplasty using Austin-Moore, Thompson, and Modular Hip Prostheses in a Tertiary Government Hospital Hansel Gould B. Cocjin, Shaun A. Porras, John Paolo J. Sanchez, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4793603/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 3 You are reading this latest preprint version Abstract Background : Hip fractures remain a significant healthcare problem worldwide, with an annual incidence of 1.7 million. Published literature regarding mortality and associated Charlson Co-morbidity score using Austin-Moore, Thompson, and Modular hip hemiarthroplasty in the Philippines is limited. Methods : This 5-year retrospective cohort study involved 92 elderly patients who underwent hip hemiarthroplasty using Austin-Moore, Thompson, or Modular hip prosthesis in the treatment of acute femoral neck fractures. A comprehensive chart review on admission and patient clinic follow-ups at 1-month, 6-months and 12-months after surgery was done. The objectives of the study included the demographic and clinical profiles, operative times, length of hospital stay, Charlson Comorbidity Score and mortality rate. Results : The average age of patients with femoral neck fractures was 73 years old. Majority were females at 81.4%; Most injuries were secondary to fall at 91.3%, whereas 8.7% were due to vehicular accidents. Patients treated with Austin-Moore, Thompson, and Modular Hip prosthesis were 31.5%, 53.2%, and 15.2% respectively. The patients had an average length of hospitalization of 11 days, and an average CC score was 4.28. There was a significant difference in estimated blood loss across the different types of prosthesis, wherein, Austin-Moore prostheses were higher with a mean difference of 125 ml and p<.05. No significant differences were found regarding operative times, length of hospital stay, Charlson Comorbidity Score and mortality rates. Conclusion . The mortality rates and associated Charlson Co-morbidity scores in patients with femoral neck fractures were comparable with published literatures. Using Austin-Moore, Thompson, and Modular hip prostheses in hip hemiarthroplasty is an effective treatment modality indicated for elderly patients with femoral neck fractures and high CCS. Therapeutic Level: III Charlson Co-morbidity Score Monopolar Hip Prostheses Femoral neck fractures Introduction The rising number of elderly populations of the world and the growing number of femoral neck fractures increase the economic burden they represent for the healthcare system. Closed reduction and internal fixation with pins or screws or primary arthroplasty are the two main options for treating displaced femoral neck fractures. 1,2 However, there is an evolving guideline on treating patients with a displaced intracapsular fractures between sixty and eighty years of age. The primary reasons for internal fixation failure are avascular necrosis and nonunion, leading to a re-intervention rate of 35% with decreased function and increased morbidity. Hemiarthroplasty prevents complications of internal fixation and significantly improves functional results. 3,4,5 Femoral neck fractures may be impacted and displaced. They are considered "fractures of necessity," best treated surgically irrespective of displacement. 6 There is an ongoing debate about which of these prostheses should be preferred over the other. Austin-Moore and Thompson monobloc prostheses are both commonly used for hemiarthroplasty for displaced femoral neck fractures. Cemented Thompson hemiarthroplasty was associated with significantly better patient satisfaction scores. 7 Few studies suggest using a bipolar prosthesis with the theoretical advantage of being modular and having two articulating surfaces, with a reportedly lower incidence of perioperative complication of dislocation. Elderly patients treated with the bipolar prosthesis were not associated with better short-term outcomes than those receiving the Thompson prosthesis. 8 The goal of the treatment is to return the patient to pre-fracture functional status. Some controversy surrounds which prosthesis is better in the management of femoral neck fractures. However, there is little data available comparing surgery mortality rate and Charlson Co-morbidity scores using a monopolar, such as Austin-Moore, Thompson prosthesis, and modular hip hemiarthroplasty in the Philippines. Therefore, a comprehensive review of patients who underwent hemiarthroplasty for femoral neck fractures was warranted in our country. Methods This retrospective cohort study included a total of 92 patients and was conducted in Corazon Locsin Montelibano Memorial Regional Hospital, a tertiary government hospital in Bacolod City, Negros Occidental, Philippines. This study was approved by the institution's PHREB Accredited Research Ethics Review Committee. The study included all patients who underwent hemiarthroplasty using Austin-Moore, Thompson, and Modular Hip Prosthesis. The Thompson and Modular Hip Prosthesis were cemented, and the Austin-Moore Prosthesis was non-cemented. Patients who had a contraindication to surgery because of high-risk medical co-morbidities not suitable to undergo hip surgery, other associated injuries such as open fractures and fractures other than femoral neck fractures, those with blunt abdominal trauma and head injuries, were excluded. The Charlson Comorbidity Score or the Charlson Comorbidity Index (CCI) was developed and validated as a measure of 1-year mortality risk and burden of disease. 9 A score of 8 has a 0.49 annual mortality rate. Patient follow-ups at 1-month, 6-month, and 1 year after surgery at the outpatient clinic were noted. Ambulation status was also determined by Functional Ambulation Category (FAC). The statistical analysis of the results was performed using SPSS software (version 20; IBM). Descriptive statistics (frequencies, percentages, cross-tabulations) were used for summarizing the data for each group. To test for the significant differences of the Charlson Comorbidity Score, length of hospital stays, operative time, days to surgery, days between surgery and discharge, ambulation status, and estimated blood loss across type of prosthesis, multiple one-way ANOVA tests were used. Tukey’s post-hoc test was used as a multiple comparisons test for significant ANOVA results. Furthermore, an independent samples t-test was used to check if there was a significant difference in ambulation status between the three types of prothesis. Lastly, Pearson’s correlation was also used to determine the correlation between the following variables: ambulation status, age, length of hospital stay, days to surgery, days between surgery and discharge, and cumulative mortality rate. Results There were 92 participants in this study with an average age of 73.46 (SD=9.6). Majority were females at 81.4%. Most of the patients sustained the injury secondary to fall (91.3%), whereas 8.7% were secondary to vehicular accidents. The type of prostheses used in the treatment of femoral neck fractures were Austin-Moore, Thompson, and Modular hip prosthesis, at 31.5%, 53.2% and 15.2 %, respectively. The average length of hospitalization was 11.29 days (SD=5.51), admission to surgery was 8.91 days (SD=5.38). Additionally, the average time interval between surgery and discharge was 3.11 days (SD=1.21). Cross Tabulations between demographic profiles, surgery statistics and type of monopolar hip prosthesis are shown in Table 1 and Table 2. The average Charlson Co-morbidity score was 4.28 (SD=1.48). A one-way ANOVA showed no significant difference in CCS across the different types of the hip prosthesis with F (2, 73) = .29 and p=.75, as shown in Table 3. The cumulative mortality rate showed that one patient died within six months, three died within one year, and 88 were still alive as of the writing of this paper. Furthermore, a One-Way ANOVA for non-parametric variables and Kurskal-Wallis test was conducted to see if there was a significant difference in mortality rate across the different types of prosthesis. There was no significant difference in mortality rate across types of prosthesis, wherein X 2 (2) =2.39 and p=.30. The correlation analysis between CCS, operative time, blood loss, duration of hospitalization, mortality rate, and ambulation status. It was discovered that CCS was significantly, negatively, and moderately correlated to operative time. This means that the higher the CCS, the shorter the operative time. Additionally, CCS was also significantly, negatively, and weakly correlated to estimated blood loss, which means that as CCS increases, estimated blood loss lessens. Other significant correlations discovered were estimated blood loss and operative, wherein there is a moderate and positive correlation, which means that as estimated blood loss increases, so does the operative time. A similar trend is seen in the relationship between estimated blood loss and length of hospital stay, wherein the higher the blood loss, the longer the hospital stay, as shown in Table 4. Lastly, there was no significant difference in ambulation status across the three groups, wherein t (89) = .00, p = .95. Patients can independently ambulate with no assistance. Furthermore, no significant difference was observed in cumulative mortality rate wherein F (1,67) = .26, p=.59. There was no significant difference in CCS, operative time, length of hospital stays, days to surgery, the time interval between surgery and discharge, estimated blood loss, and ambulation status across the different types of hip prosthesis. However, there was a significant difference in estimated blood loss across the different types of prosthesis with F (2,72) =5.56 and p<.05. It was found that those with Austin-Moore prostheses had a significantly higher level of estimated blood loss than those with Modular prostheses with a mean difference of 125.0 and p<.05. One-Way ANOVA for Type of Prosthesis as Independent Variable and Blood loss are shown in Table 5 and 6. Discussion Hemiarthroplasty remains a valuable mode of treatment for femoral neck fractures in patients aged 60 years and above. Hemiarthroplasty is a treatment that has many advantages since it allows immediate return to daily activities and avoids bed rest complications. This procedure carries the advantages of a relatively short duration of operation and reasonable clinical outcome. 10 Review studies were published in recent years about hip arthroplasty using a bipolar hip prosthesis, total hip arthroplasty, Thompson prosthesis, Austin-Moore prosthesis, Modular monopolar hip prosthesis. Variables such as the clinical outcomes, mortality, morbidity, implant failure, acetabular wear, ambulation status, and functional outcomes and suggestions have diverged. 11,12,13 The use of bipolar endoprosthesis to manage displaced femoral neck fractures in the elderly was associated with a better mean Harris hip score and would be a better option in elderly patients. 14 In developed countries, total hip arthroplasties should be considered in active physiologic patients, resulting in less pain and better functional outcomes. 15 In developing countries, it may be wise to choose the less expensive treatment modality such as the Thompson prosthesis, where the functional outcome is equally good. 15,16 Bipolar hemiarthroplasty offered a better range of movement with less pain and more stability than the fixed-head hemiarthroplasty had better functional outcome than Austin Moore hemiarthroplasty. 17,18 There are varied suggestions and recommendations on which prosthesis is superior in the treatment of femoral neck fractures. Evidence comparing the Thompson hemiarthroplasty with modular unipolar implants is weak. 19 Both cemented and uncemented hemiarthroplasty has similar outcomes. 20 Inadequate calcar seating when inserting an Austin Moore hemiarthroplasty and head size correctly affects the outcomes. 21 Functional capacity and patient satisfaction were improved with bipolar prosthesis and compared favorably to recent outcome studies. 22 Cemented hemiarthroplasties outperformed the Austin-Moore Hemiarthroplasty in pain control, implant stability, and complication rate. 23,24,25 In a contrasting study, Austin-Moore prosthesis gives a better function, safe operation, lesser pain, and improved gait function outcome even in the elderly with significant medical problems. 26 The study results showed that most of the patients having femoral neck fractures were in an elderly age group with comorbidities. The choice of the type of prosthesis was based on the fracture pattern, bone stock, and presence of arthritis. In patients older than 70, arthroplasty is recommended to allow early mobilization with good to satisfactory early functional results with lower revision rates. 27,28,29 The study also showed no significant difference in Charlson Comorbidity score across different hip prosthesis and sex types. However, there was a significant difference of CCS scores across age ranges, F (9,80) = 6.56 and p < .05. More specifically, it was found that age ranges 81–85, 86–90, and 90 + had significantly higher scores. These results support findings wherein high comorbidity patients had a higher admission rate, poorer prognosis, more extended hospital stays, and high in-hospital mortality. Our study correlates well with the prognosis, morbidity, and mortality of the patient from other literatures. 30,31 The current review showed a 3.26% mortality rate within one-year post-surgery due to medical comorbidities with no significant difference between the different types of hip prosthesis used. Our study was lower than the published reports which were 5–15% one-year mortality. 32,33 Also, data analysis showed no significant correlation between blood loss, hemoglobin, hematocrit levels, cumulative mortality rate, and ambulation status. Few studies also showed that geriatric patients undergoing hemiarthroplasty had a lower blood transfusion rate secondary to blood loss. The result suggests that whichever prosthesis can be safely considered if found to be advantageous from a longer-term outcome perspective. 34,35 Finally, there were no significant correlations between ambulation status, length of hospital stays, days to surgery, and days between surgery and discharge results found. Patients returned to the functional level that they had had before the fracture with little or no assistance during ambulation. However, current practices and guidelines suggest not to delay the surgery more than 48 hours, other than to improve an acute and treatable condition. 36,37 There is no evidence of any difference in outcome between bipolar and unipolar prostheses. However, further well-conducted randomized trials are required. 39 Lastly, the clinical and cost-effectiveness of the newer hemiarthroplasty stems need to be ascertained through well-designed comparative studies. 40, 41,42,43 Conclusion The mortality rate and CCS scores were comparably good in using monopolar hip hemiarthroplasty prostheses such as the Thompson prosthesis, Austin Moore Prosthesis, and Modular hip prosthesis in the treatment of femoral neck fractures in an elderly population. There was no significant difference in CCS, operative time, length of hospital stays, days to surgery, the time interval between surgery and discharge, estimated blood loss, and ambulation status across the different types of hip prosthesis included in the study. Declarations Conflict of Interest: The authors declare that they have no conflict of interest. Funding: There is no funding source. Availability of data and material (data transparency): Not applicable. Consent for Publication: Not applicable. Consent to Participate: Not applicable. Authors’ contributions : Hansel Gould B. Cocjin, MD., Shaun A. Porras, MD, John Paolo J. Sanchez, MD., and Joevel Christian T. Bajao, MD., contributed to the study conception, design, application for approval, material preparation, data collection, analysis, and writing. All authors read and approved the final manuscript. Acknowledgements: Not applicable. Ethical Approval: The study was performed in accordance with the ethical standards as lain down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the institution’s PHREB accredited Ethics Review Committee. References Miyamoto RG, Kaplan KM, Levine BR, Egol KA, Zuckerman JD. Surgical management of hip fractures: an evidence-based review of the literature. I: femoral neck fractures. J Am Acad Orthop Surg. 2008 Oct;16(10):596-607. doi: 10.5435/00124635-200810000-00005. PMID: 18832603. 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Cemented Thompson's hemiarthroplasty in patients with intracapsular neck of femur fractures: survival analysis of 1,670 procedures. Eur J Orthop Surg Traumatol. 2015 May;25(4):655-60. doi: 10.1007/s00590-014-1521-1. Epub 2014 Sep 27. PMID: 25260576. Gashi YN, Elhadi AS, Elbushra IM. Outcome of Primary Cemented Bipolar Hemiarthroplasty compared with Dynamic Hip Screw in Elderly Patients with Unstable Intertrochanteric Fracture. Malays Orthop J. 2018 Mar;12(1):36-41. doi: 10.5704/MOJ.1803.007. PMID: 29725511; PMCID: PMC5920257. Ravikumar KJ, Marsh G. Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur-13-year results of a prospective randomised study. Injury. 2000 Dec;31(10):793-7. doi: 10.1016/s0020-1383(00)00125-x. PMID: 11154750. Tol MC, van den Bekerom MP, Sierevelt IN, Hilverdink EF, Raaymakers EL, Goslings JC. Hemiarthroplasty or total hip arthroplasty for the treatment of a displaced intracapsular fracture in active elderly patients: 12-year follow-up of randomised trial. Bone Joint J. 2017 Feb;99-B (2):250-254. doi: 10.1302/0301-620X.99B2.BJJ-2016-0479.R1. PMID: 28148669. Tables Table 1. Demographics Profiles Type of Hip Prosthesis Austin-Moore (n=29) Thompson (n=49) Modular (n=14) Frequency Percentage Frequency Percentage Frequency Percentage Age 41-50 1 3.8 1 2.0 0 0.0 51-60 4 13.8 1 2.0 2 14.2 61-70 4 13.8 12 24.5 4 28.4 71-80 12 31.4 23 46.9 8 47.0 81-90 2 6.9 10 21.6 0 0.0 91-100 1 3.8 2 4.1 0 0.0 Gender Male 8 19.0 12 19.5 3 21.4 Female 21 81.0 37 81.5 11 79.6 Nature of Injury Fall 25 86.2 47 95.9 13 92.9 Motor Vehicular Accident 4 13.8 2 4.1 1 7.1 Table 2. Surgery Statistics Type of Hip Prosthesis Austin-Moore (n=29) Thompson (n=49) Modular (n=14) Mean SD Mean SD Mean SD Operative time(minutes) 87.33 36.67 86.54 26.27 77.50 18.05 Length of stay (days) 13.57 5.24 11.83 5.47 10.21 3.96 Days to surgery 10.62 5.38 8.61 5.70 7.21 3.79 The time interval between surgery and discharge (days) 2.95 .97 3.22 1.44 3.00 .68 Table 3. Charlson Comorbidity Score and Type of Hip Prosthesis Variables Type of Hip Prosthesis Austin-Moore Thompson Modular ANOVA F-ratio p-value Interpretation Mean ( SD ) CCS 3.95 ( 1.53) 4.20 ( 1.52 ) 3.93 (1.07 ) .29 .75 No Significant Difference Table 4. Correlations Between Charlson Comorbidty Score, Operative Time, Blood Loss, Hospital Duration, Mortality Rate, and Ambulation Status. Variables Charslon Comorbidity Score Operative Time Estimated Blood Loss Length of Hospital Stay Days to Surgery Days Between Surgery and Discharge Cumulative Mortality Rate Ambulation Status Charslon Comorbidty Score --- Operative Time -.42* --- Estimated Blood Loss -.25* .48* --- Length of Hospital Stay -.15 -.03 .25* --- Days to Surgery -.08 -.04 .23* .98* --- Days Between Surgery and Discharge -.02 .05 .05 -.01 -.24 --- Cumulative Mortality Rate -.17 -.04 .06 -.19 -.10 -.19 --- Ambulation Status -.07 .03 -.15 .12 -.05 .20 -.16 --- Table 5: One-Way ANOVA for Type of Prosthesis as Independent Variable Variables M ( SD) F-Ratio p-value Interpretation Austin-Moore Thompson Modular CCS 3.95 ( 1.53) 4.20 ( 1.52 ) 3.93 (1.07 ) .29 .75 No Significant Difference Operative Time 87.33 (36.67) 86.54 (26.27) 77.50 (18.05) .62 .54 No Significant Difference Length of Hospital Stay 13.57 ( 5.24) 11.83 (5.47) 10.21 (3.96) 1.83 .17 No Significant Difference Days to Surgery 10.62 (5.38) 8.61 (5.70) 7.21 (3.79) 1.86 .16 No Significant Difference Days Between Surgery and Discharge 2.95 (.97) 3.22 (1.44) 3.00 (.68) .40 .67 No Significant Difference Estimated Blood Loss 262.86 (145.47) 206.75 (99.62) 137.86 (58.20) 5.56 .01 Significant Difference (Austin-Moore significantly higher blood loss than Modular) Ambulation Status 3.29 (1.01) 3.95 (1.47) 4.07 (1.27) 2.16 .12 No Significant Difference Table 6: Tukey’s Post-Hoc Test of Multiple Comparisons for Type of Prosthesis and Estimated Blood Loss Mean Difference Austin-Moore Thompson Modular Austin-Moore --- Thompson 56.1 --- Modular 125.0* 68.9 --- Additional Declarations No competing interests reported. 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Cocjin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEElEQVRIiWNgGAWjYBACAzBZAMTsYDYbDwN7A0jcgoAWEMkM08JzACQiQbQWIJBIAJM4tZiznz384YNBrZzBYeaNHz7U8MmYSz6/uuFHgQQDf3t3AjYtlj15aZIzDI4bGxxmK5accYyNx3J2TtnNHqDDJM6c3YDVYQdyzJh5DI4lbjjMY8bM28DGY3A7J+0GD1CLgUQudi3n3xh//oOi5eaZtJt/8Gm5kWMgzWBQg6TlBvux23htufHGTLLH4ICxJMwvBmdy2G7LGEjw4PTL+RzjDz8q6uT4jjeDQuyYvcHx489uvvljI8ff3otVCxQchjGOATEPOIJ48CgHgToYowaI2R8QUD0KRsEoGAUjDAAA9GJhOM2HBjQAAAAASUVORK5CYII=","orcid":"","institution":"Corazon Locsin Montelibano Memorial Regional Hospital","correspondingAuthor":true,"prefix":"","firstName":"Hansel","middleName":"Gould B.","lastName":"Cocjin","suffix":""},{"id":332026679,"identity":"4041c3c2-12c8-4fbd-92ec-4fae7040f75c","order_by":1,"name":"Shaun A. Porras","email":"","orcid":"","institution":"Corazon Locsin Montelibano Memorial Regional Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shaun","middleName":"A.","lastName":"Porras","suffix":""},{"id":332026681,"identity":"8986a471-d23d-432c-b64b-784bc295780a","order_by":2,"name":"John Paolo J. Sanchez","email":"","orcid":"","institution":"Corazon Locsin Montelibano Memorial Regional Hospital","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"Paolo J.","lastName":"Sanchez","suffix":""},{"id":332026683,"identity":"d0bbe7e8-e5bc-408e-849a-87a401562b45","order_by":3,"name":"Joevel Christian T. Bajao","email":"","orcid":"","institution":"Corazon Locsin Montelibano Memorial Regional Hospital","correspondingAuthor":false,"prefix":"","firstName":"Joevel","middleName":"Christian T.","lastName":"Bajao","suffix":""}],"badges":[],"createdAt":"2024-07-24 08:26:06","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4793603/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4793603/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":62925794,"identity":"60a288d7-6e6d-4b3f-8fd5-efa3f4cf9345","added_by":"auto","created_at":"2024-08-21 06:40:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":610040,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4793603/v1/73b73773-ed8c-4747-b5f5-961e14d9e57e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Mortality Rate and Charlson Co-morbidity Scores of Patients with Femoral Neck Fractures Treated with Hip Hemiarthroplasty using Austin-Moore, Thompson, and Modular Hip Prostheses in a Tertiary Government Hospital","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe rising number of elderly populations of the world and the growing number of femoral neck fractures increase the economic burden they represent for the healthcare system. Closed reduction and internal fixation with pins or screws or primary arthroplasty are the two main options for treating displaced femoral neck fractures.\u003csup\u003e1,2\u003c/sup\u003e However, there is an evolving guideline on treating patients with a displaced intracapsular fractures between sixty and eighty years of age. The primary reasons for internal fixation failure are avascular necrosis and nonunion, leading to a re-intervention rate of 35% with decreased function and increased morbidity. Hemiarthroplasty prevents complications of internal fixation and significantly improves functional results.\u003csup\u003e3,4,5\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eFemoral neck fractures may be impacted and displaced. They are considered \"fractures of necessity,\" best treated surgically irrespective of displacement.\u003csup\u003e6\u003c/sup\u003e There is an ongoing debate about which of these prostheses should be preferred over the other. Austin-Moore and Thompson monobloc prostheses are both commonly used for hemiarthroplasty for displaced femoral neck fractures. Cemented Thompson hemiarthroplasty was associated with significantly better patient satisfaction scores.\u003csup\u003e7\u003c/sup\u003e Few studies suggest using a bipolar prosthesis with the theoretical advantage of being modular and having two articulating surfaces, with a reportedly lower incidence of perioperative complication of dislocation. Elderly patients treated with the bipolar prosthesis were not associated with better short-term outcomes than those receiving the Thompson prosthesis.\u003csup\u003e8\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe goal of the treatment is to return the patient to pre-fracture functional status. Some controversy surrounds which prosthesis is better in the management of femoral neck fractures. However, there is little data available comparing surgery mortality rate and Charlson Co-morbidity scores using a monopolar, such as Austin-Moore, Thompson prosthesis, and modular hip hemiarthroplasty in the Philippines. Therefore, a comprehensive review of patients who underwent hemiarthroplasty for femoral neck fractures was warranted in our country.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e This retrospective cohort study included a total of 92 patients and was conducted in Corazon Locsin Montelibano Memorial Regional Hospital, a tertiary government hospital in Bacolod City, Negros Occidental, Philippines. This study was approved by the institution's PHREB Accredited Research Ethics Review Committee. The study included all patients who underwent hemiarthroplasty using Austin-Moore, Thompson, and Modular Hip Prosthesis. The Thompson and Modular Hip Prosthesis were cemented, and the Austin-Moore Prosthesis was non-cemented. Patients who had a contraindication to surgery because of high-risk medical co-morbidities not suitable to undergo hip surgery, other associated injuries such as open fractures and fractures other than femoral neck fractures, those with blunt abdominal trauma and head injuries, were excluded. The Charlson Comorbidity Score or the Charlson Comorbidity Index (CCI) was developed and validated as a measure of 1-year mortality risk and burden of disease.\u003csup\u003e9\u003c/sup\u003e A score of \u0026lt;\u0026thinsp;3 has a 0.03, 4\u0026ndash;5 has a 0.13, 6\u0026ndash;7 has a 0.27 and \u0026gt;\u0026thinsp;8 has a 0.49 annual mortality rate. Patient follow-ups at 1-month, 6-month, and 1 year after surgery at the outpatient clinic were noted. Ambulation status was also determined by Functional Ambulation Category (FAC). The statistical analysis of the results was performed using SPSS software (version 20; IBM). Descriptive statistics (frequencies, percentages, cross-tabulations) were used for summarizing the data for each group. To test for the significant differences of the Charlson Comorbidity Score, length of hospital stays, operative time, days to surgery, days between surgery and discharge, ambulation status, and estimated blood loss across type of prosthesis, multiple one-way ANOVA tests were used. Tukey\u0026rsquo;s post-hoc test was used as a multiple comparisons test for significant ANOVA results. Furthermore, an independent samples t-test was used to check if there was a significant difference in ambulation status between the three types of prothesis. Lastly, Pearson\u0026rsquo;s correlation was also used to determine the correlation between the following variables: ambulation status, age, length of hospital stay, days to surgery, days between surgery and discharge, and cumulative mortality rate.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThere were 92 participants in this study with an average age of 73.46 (SD=9.6). Majority were females at 81.4%. Most of the patients sustained the injury secondary to fall (91.3%), whereas 8.7% were secondary to vehicular accidents. The type of prostheses used in the treatment of femoral neck fractures were Austin-Moore, Thompson, and Modular hip prosthesis, at 31.5%, 53.2% and 15.2 %, respectively. The average length of hospitalization was 11.29 days (SD=5.51), admission to surgery was 8.91 days (SD=5.38). Additionally, the average time interval between surgery and discharge was 3.11 days (SD=1.21). Cross Tabulations between demographic profiles, surgery statistics and type of monopolar hip prosthesis are shown in Table 1 and Table 2. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe average Charlson Co-morbidity score was 4.28 (SD=1.48).\u0026nbsp;A one-way ANOVA showed no significant difference in CCS across the different types of the hip prosthesis with F (2, 73) = .29 and p=.75, as shown in Table 3.\u0026nbsp;The cumulative mortality rate showed that one patient died within six months, three died within one year, and 88 were still alive as of the writing of this paper. Furthermore, a One-Way ANOVA for non-parametric variables and Kurskal-Wallis test was conducted to see if there was a significant difference in mortality rate across the different types of prosthesis. There was no significant difference in mortality rate across types of prosthesis, wherein X\u003csup\u003e2\u003c/sup\u003e(2) =2.39 and p=.30.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe correlation analysis between CCS, operative time, blood loss, duration of hospitalization, mortality rate, and ambulation status. It was discovered that CCS was significantly, negatively, and moderately correlated to operative time. This means that the higher the CCS, the shorter the operative time. Additionally, CCS was also significantly, negatively, and weakly correlated to estimated blood loss, which means that as CCS increases, estimated blood loss lessens. Other significant correlations discovered were estimated blood loss and operative, wherein there is a moderate and positive correlation, which means that as estimated blood loss increases, so does the operative time. A similar trend is seen in the relationship between estimated blood loss and length of hospital stay, wherein the higher the blood loss, the longer the hospital stay, as shown in Table 4.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLastly, there was no significant difference in ambulation status across the three groups, wherein t (89) = .00, p = .95. Patients can independently ambulate with no assistance. Furthermore, no significant difference was observed in cumulative mortality rate wherein F (1,67) = .26, p=.59. There was no significant difference in CCS, operative time, length of hospital stays, days to surgery, the time interval between surgery and discharge, estimated blood loss, and ambulation status across the different types of hip prosthesis. However, there was a significant difference in estimated blood loss across the different types of prosthesis with F (2,72) =5.56 and p\u0026lt;.05. It was found that those with Austin-Moore prostheses had a significantly higher level of estimated blood loss than those with Modular prostheses with a mean difference of 125.0 and p\u0026lt;.05. One-Way ANOVA for Type of Prosthesis as Independent Variable and Blood loss are shown in Table 5 and 6.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eHemiarthroplasty remains a valuable mode of treatment for femoral neck fractures in patients aged 60 years and above. Hemiarthroplasty is a treatment that has many advantages since it allows immediate return to daily activities and avoids bed rest complications. This procedure carries the advantages of a relatively short duration of operation and reasonable clinical outcome.\u003csup\u003e10\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eReview studies were published in recent years about hip arthroplasty using a bipolar hip prosthesis, total hip arthroplasty, Thompson prosthesis, Austin-Moore prosthesis, Modular monopolar hip prosthesis. Variables such as the clinical outcomes, mortality, morbidity, implant failure, acetabular wear, ambulation status, and functional outcomes and suggestions have diverged.\u003csup\u003e11,12,13\u003c/sup\u003e The use of bipolar endoprosthesis to manage displaced femoral neck fractures in the elderly was associated with a better mean Harris hip score and would be a better option in elderly patients.\u003csup\u003e14\u003c/sup\u003e In developed countries, total hip arthroplasties should be considered in active physiologic patients, resulting in less pain and better functional outcomes.\u003csup\u003e15\u003c/sup\u003e In developing countries, it may be wise to choose the less expensive treatment modality such as the Thompson prosthesis, where the functional outcome is equally good.\u003csup\u003e15,16\u003c/sup\u003e Bipolar hemiarthroplasty offered a better range of movement with less pain and more stability than the fixed-head hemiarthroplasty had better functional outcome than Austin Moore hemiarthroplasty.\u003csup\u003e17,18\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThere are varied suggestions and recommendations on which prosthesis is superior in the treatment of femoral neck fractures. Evidence comparing the Thompson hemiarthroplasty with modular unipolar implants is weak.\u003csup\u003e19\u003c/sup\u003e Both cemented and uncemented hemiarthroplasty has similar outcomes.\u003csup\u003e20\u003c/sup\u003e Inadequate calcar seating when inserting an Austin Moore hemiarthroplasty and head size correctly affects the outcomes.\u003csup\u003e21\u003c/sup\u003e Functional capacity and patient satisfaction were improved with bipolar prosthesis and compared favorably to recent outcome studies.\u003csup\u003e22\u003c/sup\u003e Cemented hemiarthroplasties outperformed the Austin-Moore Hemiarthroplasty in pain control, implant stability, and complication rate.\u003csup\u003e23,24,25\u003c/sup\u003e In a contrasting study, Austin-Moore prosthesis gives a better function, safe operation, lesser pain, and improved gait function outcome even in the elderly with significant medical problems.\u003csup\u003e26\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe study results showed that most of the patients having femoral neck fractures were in an elderly age group with comorbidities. The choice of the type of prosthesis was based on the fracture pattern, bone stock, and presence of arthritis. In patients older than 70, arthroplasty is recommended to allow early mobilization with good to satisfactory early functional results with lower revision rates.\u003csup\u003e27,28,29\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe study also showed no significant difference in Charlson Comorbidity score across different hip prosthesis and sex types. However, there was a significant difference of CCS scores across age ranges, F (9,80)\u0026thinsp;=\u0026thinsp;6.56 and p\u0026thinsp;\u0026lt;\u0026thinsp;.05. More specifically, it was found that age ranges 81\u0026ndash;85, 86\u0026ndash;90, and 90\u0026thinsp;+\u0026thinsp;had significantly higher scores. These results support findings wherein high comorbidity patients had a higher admission rate, poorer prognosis, more extended hospital stays, and high in-hospital mortality. Our study correlates well with the prognosis, morbidity, and mortality of the patient from other literatures.\u003csup\u003e30,31\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe current review showed a 3.26% mortality rate within one-year post-surgery due to medical comorbidities with no significant difference between the different types of hip prosthesis used. Our study was lower than the published reports which were 5\u0026ndash;15% one-year mortality.\u003csup\u003e32,33\u003c/sup\u003e Also, data analysis showed no significant correlation between blood loss, hemoglobin, hematocrit levels, cumulative mortality rate, and ambulation status. Few studies also showed that geriatric patients undergoing hemiarthroplasty had a lower blood transfusion rate secondary to blood loss. The result suggests that whichever prosthesis can be safely considered if found to be advantageous from a longer-term outcome perspective.\u003csup\u003e34,35\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eFinally, there were no significant correlations between ambulation status, length of hospital stays, days to surgery, and days between surgery and discharge results found. Patients returned to the functional level that they had had before the fracture with little or no assistance during ambulation. However, current practices and guidelines suggest not to delay the surgery more than 48 hours, other than to improve an acute and treatable condition.\u003csup\u003e36,37\u003c/sup\u003e There is no evidence of any difference in outcome between bipolar and unipolar prostheses. However, further well-conducted randomized trials are required.\u003csup\u003e39\u003c/sup\u003e Lastly, the clinical and cost-effectiveness of the newer hemiarthroplasty stems need to be ascertained through well-designed comparative studies. \u003csup\u003e40, 41,42,43\u003c/sup\u003e\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe mortality rate and CCS scores were comparably good in using monopolar hip hemiarthroplasty prostheses such as the Thompson prosthesis, Austin Moore Prosthesis, and Modular hip prosthesis in the treatment of femoral neck fractures in an elderly population. There was no significant difference in CCS, operative time, length of hospital stays, days to surgery, the time interval between surgery and discharge, estimated blood loss, and ambulation status across the different types of hip prosthesis included in the study.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u003c/strong\u003e The authors declare that they have no conflict of interest. \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e There is no funding source.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material (data transparency):\u003c/strong\u003e Not applicable.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication:\u003c/strong\u003e Not applicable.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Participate:\u003c/strong\u003e Not applicable.\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e: Hansel Gould B. Cocjin, MD., Shaun A. Porras, MD, John Paolo J. Sanchez, MD., and Joevel Christian T. Bajao, MD., contributed to the study conception, design, application for approval, material preparation, data collection, analysis, and writing. All authors read and approved the final manuscript.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e Not applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval:\u003c/strong\u003e The study was performed in accordance with the ethical standards as lain down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the institution\u0026rsquo;s PHREB accredited Ethics Review Committee.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMiyamoto RG, Kaplan KM, Levine BR, Egol KA, Zuckerman JD. Surgical management of hip fractures: an evidence-based review of the literature. I: femoral neck fractures. J Am Acad Orthop Surg. 2008 Oct;16(10):596-607. doi: 10.5435/00124635-200810000-00005. PMID: 18832603.\u003c/li\u003e\n\u003cli\u003eNicoll EA. The Unsolved Fracture. The Journal of Bone and Joint Surgery British volume. 1963;45-B (2):239\u0026ndash;41.\u003c/li\u003e\n\u003cli\u003eRogmark C, Carlsson A, Johnell O, Sernbo I. A prospective randomised trial of internal fixation versus arthroplasty for displaced fractures of the neck of the femur. Functional outcome for 450 patients at two years. J Bone Joint Surg Br. 2002 Mar;84(2):183-8. doi: 10.1302/0301-620x.84b2.11923. PMID: 11922358.\u003c/li\u003e\n\u003cli\u003eFilipov O. Epidemiology and Social Burden Of The Femoral Neck Fractures. Journal of IMAB - Annual Proceeding (Scientific Papers). 2014;20(4):516\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eLu-Yao GL, Keller RB, Littenberg B, Wennberg JE. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports. J Bone Joint Surg Am. 1994 Jan;76(1):15-25. doi: 10.2106/00004623-199401000-00003. PMID: 8288658.\u003c/li\u003e\n\u003cli\u003eBendale M, V NK. Comparison of Unipolar (Moore\u0026rsquo;S Prosthesis) And Bipolar Hemiarthroplasty In Fracture Neck Of Femur In The Elderly- A Short-Term Prospective Study. Journal of Evidence Based Medicine and Healthcare. 2016;3(92):5011\u0026ndash;22.\u003c/li\u003e\n\u003cli\u003eSingh GK, Deshmukh RG. Uncemented Austin-Moore and cemented Thompson unipolar hemiarthroplasty for displaced fracture neck of femur--comparison of complications and patient satisfaction. Injury. 2006 Feb;37(2):169-74. doi: 10.1016/j.injury.2005.09.016. Epub 2006 Jan 17. PMID: 16413024.\u003c/li\u003e\n\u003cli\u003eBauer S, Isenegger P, Gautschi OP, Ho KM, Yates PJ, Zellweger R. Cemented Thompson versus cemented bipolar prostheses for femoral neck fractures. J Orthop Surg (Hong Kong). 2010 Aug;18(2):166-71. doi: 10.1177/230949901001800207. PMID: 20808006.\u003c/li\u003e\n\u003cli\u003eCharlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. doi: 10.1016/0021-9681(87)90171-8. PMID: 3558716.\u003c/li\u003e\n\u003cli\u003eSiraj, M., Khan, RM., Iqbal, MJ., Kamran, K., Hussain, M., Rehman, SU. The Outcome of Hemiarthroplasty for Neck of Femur Fractures in Terms of Harris Hip Score. P J M H S Vol. 7, NO. 3, JUL \u0026ndash; SEP 2013 814.\u003c/li\u003e\n\u003cli\u003eHEALTH Investigators, Bhandari M, Einhorn TA, Guyatt G, Schemitsch EH, Zura RD, Sprague S, Frihagen F, Guerra-Farf\u0026aacute;n E, Kleinlugtenbelt YV, Poolman RW, Rangan A, Bzovsky S, Heels-Ansdell D, Thabane L, Walter SD, Devereaux PJ. Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture. N Engl J Med. 2019 Dec 5;381(23):2199-2208. doi: 10.1056/NEJMoa1906190. Epub 2019 Sep 26. PMID: 31557429.\u003c/li\u003e\n\u003cli\u003eLin CC, Yang CC, Yu TC. Comparison of Mid-term Survivorship and Clinical Outcomes between Bipolar Hemiarthroplasty and Total Hip Arthroplasty with Cementless Stem: A Multicenter Retrospective Study. Orthop Surg. 2019 Apr;11(2):221-228. doi: 10.1111/os.12440. Epub 2019 Apr 12. PMID: 30977594; PMCID: PMC6594502.\u003c/li\u003e\n\u003cli\u003eBlomfeldt R, T\u0026ouml;rnkvist H, Eriksson K, S\u0026ouml;derqvist A, Ponzer S, Tidermark J. A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. J Bone Joint Surg Br. 2007 Feb;89(2):160-5. doi: 10.1302/0301-620X.89B2.18576. PMID: 17322427.\u003c/li\u003e\n\u003cli\u003eSomashekar, Krishna SV, Sridhara Murthy J. Treatment of femoral neck fractures: unipolar versus bipolar hemiarthroplasty. Malays Orthop J. 2013 Jul;7(2):6-11. doi: 10.5704/MOJ.1307.007. PMID: 25722818; PMCID: PMC4341030.\u003c/li\u003e\n\u003cli\u003eN Narayan KK, George T. Functional outcome of fracture neck of femur treated with total hip replacement versus bipolar arthroplasty in a South Asian population. Arch Orthop Trauma Surg. 2006 Oct;126(8):545-8. doi: 10.1007/s00402-006-0182-x. Epub 2006 Jul 12. PMID: 16835776.\u003c/li\u003e\n\u003cli\u003eParker MJ. Cemented Thompson hemiarthroplasty versus cemented Exeter Trauma Stem (ETS) hemiarthroplasty for intracapsular hip fractures: a randomised trial of 200 patients. Injury. 2012 Jun;43(6):807-10. doi: 10.1016/j.injury.2011.09.018. Epub 2011 Oct 13. PMID: 22000824.\u003c/li\u003e\n\u003cli\u003eAbdelkhalek M, Abdelwahab M, Ali AM. Bipolar versus fixed-head hip arthroplasty for femoral neck fractures in elderly patients. Strategies Trauma Limb Reconstr. 2011 Apr;6(1):1-6. doi: 10.1007/s11751-010-0100-1. Epub 2011 Jan 22. PMID: 21589675; PMCID: PMC3058187.\u003c/li\u003e\n\u003cli\u003eKhan, KM., Khanzada, MA., Memon, IA. Functional Outcome of Austin Moore Prosthesis (AMP) versus Bipolar Prosthesis in fracture neck of femur. JOURNAL OF PAKISTAN ORTHOPAEDIC ASSOCIATION VOL. 30 NO. 4 (2018).\u003c/li\u003e\n\u003cli\u003eSims AL, Farrier AJ, Reed MR, Sheldon TA. Thompson hemiarthroplasty \u003cem\u003eversus\u003c/em\u003e modular unipolar implants for patients requiring hemiarthroplasty of the hip: A systematic review of the evidence. Bone Joint Res. 2017 Aug;6(8):506-513. doi: 10.1302/2046-3758.68.BJR-2016-0256.R1. PMID: 28851695; PMCID: PMC5579310.\u003c/li\u003e\n\u003cli\u003eGowtham, K., Gubbi, SD., Prasad, P. A Comparative Study of the Postoperative Morbidity and Mortality in Femoral Neck Fractures in Elderly Patients Treated with Cemented and Uncemented Thompson Hemiarthroplasty. Journal of Orthopaedics, Trauma, and Rehabilitation 15 (2011) 47e50.\u003c/li\u003e\n\u003cli\u003eSharif KM, Parker MJ. Austin Moore hemiarthroplasty: technical aspects and their effects on outcome, in patients with fractures of the neck of femur. Injury. 2002 Jun;33(5):419-22. doi: 10.1016/s0020-1383(02)00041-4. PMID: 12095722.\u003c/li\u003e\n\u003cli\u003eRai AK, Agarwal R, Singh S, Ratan R. The BHU bicentric bipolar prosthesis in fracture neck femur in active elderly. J Trauma Manag Outcomes. 2008 Sep 25;2(1):7. doi: 10.1186/1752-2897-2-7. PMID: 18817566; PMCID: PMC2586620.\u003c/li\u003e\n\u003cli\u003eFang C, Liu RP, Lau TW, Leung A, Wong TM, Pun T, Leung F. Is It Time to Phase Out the Austin Moore Hemiarthroplasty? A Propensity Score Matched Case Control Comparison versus Cemented Hemiarthroplasty. Biomed Res Int. 2016:7627216. doi: 10.1155/2016/7627216. Epub 2016 Mar 6. PMID: 27042669; PMCID: PMC4799807.\u003c/li\u003e\n\u003cli\u003eAmit, K., Yaron, B., Alexander, L., Rostislav, N., David, R. Functional Outcome after Partial Hip Replacement for Femoral Neck Fracture (Subcapital Fracture) with Austin Moore Prosthesis. Journal of Trauma \u0026amp; Treatment DOI:10.4172/2167-1222.1000188 Corpus ID: 9023782.\u003c/li\u003e\n\u003cli\u003eAlshawabkeh, J., Al-Zaben, R., Jbarat, A. A Comparative Study of Hemiarthroplasty for Neck of Femur Fracture of Elderly (Bipolar, Austin Moore, Cemented Thompson). Journal of the Royal Medical Services. DOI:10.12816/0032202 Corpus ID: 57665769.\u003c/li\u003e\n\u003cli\u003eRahaman, M., Nagakumar Js., Harsha, M. Role of Austin-Moore prosthesis in intracapsular fracture neck of femur in elderly. International Journal of Orthopaedics Sciences. DOI: 10.22271/ortho.2019.v5.i4b.1654 Corpus ID: 208444144.\u003c/li\u003e\n\u003cli\u003eMarais, LC., Ferreira, N. Management of femoral neck fractures. SA Orthopaedic Journal Autumn 2013.Vol 12. No 1. 58-62.\u003c/li\u003e\n\u003cli\u003eAgarwal, VK., Singh, A., Narula, R., Tiwari, G. A study of surgical management of fracture neck of femur in elderly with bipolar hemiarthroplasty. International Journal of Contemporary Medical Research 2016;3(6):1790-1793.\u003c/li\u003e\n\u003cli\u003eEl-Abed K, McGuinness A, Brunner J, Dallovedova P, O\u0026apos;Connor P, Kennedy JG. Comparison of outcomes following uncemented hemiarthroplasty and dynamic hip screw in the treatment of displaced subcapital hip fractures in patients aged greater than 70 years. Acta Orthop Belg. 2005 Feb;71(1):48-54. PMID: 15792207.\u003c/li\u003e\n\u003cli\u003eRoffman, CE., Buchanana, J., Allisona, GT. Charlson Comorbidities Index. Journal of Physiotherapy 62 (2016) 171.\u003c/li\u003e\n\u003cli\u003eWang HY, Chew G, Kung CT, Chung KJ, Lee WH. The use of Charlson comorbidity index for patients revisiting the emergency department within 72 hours. Chang Gung Med J. 2007 Sep-Oct;30(5):437-44. PMID: 18062175.\u003c/li\u003e\n\u003cli\u003eBurgers PT, Van Geene AR, Van den Bekerom MP, Van Lieshout EM, Blom B, Aleem IS, Bhandari M, Poolman RW. Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis and systematic review of randomized trials. Int Orthop. 2012 Aug;36(8):1549-60. doi: 10.1007/s00264-012-1569-7. Epub 2012 May 24. PMID: 22623062; PMCID: PMC3535035.\u003c/li\u003e\n\u003cli\u003eKwok DC, Cruess RL. A retrospective study of Moore and Thompson hemiarthroplasty. A review of 599 surgical cases and an analysis of the technical complications. Clin Orthop Relat Res. 1982 Sep;(169):179-85. PMID: 7105576.\u003c/li\u003e\n\u003cli\u003eLoo, WL., Loh, SY., Lee, HC. Is there a Significant Difference in Surgery and Outcomes between Unipolar and Bipolar Hip Hemiarthroplasty? A Retrospective Study of a Single Institution in Singapore. Malaysian Orthopaedic Journal 2011 Vol 5 No 1.\u003c/li\u003e\n\u003cli\u003eHaynes MS, Ondeck NT, Ottesen TD, Malpani R, Rubin LE, Grauer JN. Perioperative Outcomes of Hemiarthroplasty Versus Total Hip Arthroplasty for Geriatric Hip Fracture: The Importance of Studying Matched Populations. J Arthroplasty. 2020 Nov;35(11):3188-3194. doi: 10.1016/j.arth.2020.06.015. Epub 2020 Jun 15. PMID: 32654940.\u003c/li\u003e\n\u003cli\u003eSakr M, Girard J, Fakih R. Retrospective evaluation of bipolar hip arthroplasty in fractures of the proximal femur. North Am J Med Sci 2010; 2: 409-415.\u003c/li\u003e\n\u003cli\u003eSiegmeth AW, Gurusamy K, Parker MJ. Delay to surgery prolongs hospital stay in patients with fractures of the proximal femur. J Bone Joint Surg Br. 2005 Aug;87(8):1123-6. doi: 10.1302/0301-620X.87B8.16357. PMID: 16049251.\u003c/li\u003e\n\u003cli\u003eManoharan G, Morley D, Chatterton BD, Moores TS, Roberts PJ. Uncemented Thompson\u0026apos;s hemiarthroplasty: safe, palliative and cost-effective surgery in the infirm patient-a consecutive series of 1445 cases. Eur J Orthop Surg Traumatol. 2018 Aug;28(6):1103-1109. doi: 10.1007/s00590-018-2144-8. Epub 2018 Feb 8. Erratum in: Eur J Orthop Surg Traumatol. 2020 Apr;30(3):553. PMID: 29423867.\u003c/li\u003e\n\u003cli\u003eParker MJ, Gurusamy KS, Azegami S. Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev. 2010 Jun 16;(6):CD001706. doi: 10.1002/14651858.CD001706.pub4. PMID: 20556753.\u003c/li\u003e\n\u003cli\u003eKhan SK, Jameson SS, Sims A, A\u0026apos;Court J, Reed MR, Rangan A, Muller SD. Cemented Thompson\u0026apos;s hemiarthroplasty in patients with intracapsular neck of femur fractures: survival analysis of 1,670 procedures. Eur J Orthop Surg Traumatol. 2015 May;25(4):655-60. doi: 10.1007/s00590-014-1521-1. Epub 2014 Sep 27. PMID: 25260576.\u003c/li\u003e\n\u003cli\u003eGashi YN, Elhadi AS, Elbushra IM. Outcome of Primary Cemented Bipolar Hemiarthroplasty compared with Dynamic Hip Screw in Elderly Patients with Unstable Intertrochanteric Fracture. Malays Orthop J. 2018 Mar;12(1):36-41. doi: 10.5704/MOJ.1803.007. PMID: 29725511; PMCID: PMC5920257.\u003c/li\u003e\n\u003cli\u003eRavikumar KJ, Marsh G. Internal fixation versus hemiarthroplasty versus total hip arthroplasty for displaced subcapital fractures of femur-13-year results of a prospective randomised study. Injury. 2000 Dec;31(10):793-7. doi: 10.1016/s0020-1383(00)00125-x. PMID: 11154750.\u003c/li\u003e\n\u003cli\u003eTol MC, van den Bekerom MP, Sierevelt IN, Hilverdink EF, Raaymakers EL, Goslings JC. Hemiarthroplasty or total hip arthroplasty for the treatment of a displaced intracapsular fracture in active elderly patients: 12-year follow-up of randomised trial. Bone Joint J. 2017 Feb;99-B (2):250-254. doi: 10.1302/0301-620X.99B2.BJJ-2016-0479.R1. PMID: 28148669.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1. Demographics\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eProfiles\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.693418940609952%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.30658105939006%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eType of Hip Prosthesis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"33.397683397683394%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eAustin-Moore (n=29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.397683397683394%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eThompson (n=49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"33.204633204633204%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eModular (n=14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.698656429942417%\" valign=\"top\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.698656429942417%\" valign=\"top\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.698656429942417%\" valign=\"top\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.698656429942417%\" valign=\"top\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.698656429942417%\" valign=\"top\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.50671785028791%\" valign=\"top\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cem\u003eAge\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003e41-50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003e51-60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e14.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003e61-70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e24.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e28.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003e71-80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e31.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e46.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e47.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003e81-90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e21.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003e91-100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e0.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cem\u003eGender\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e19.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e19.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e21.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e81.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e81.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e79.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cem\u003eNature of Injury\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003eFall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e86.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e95.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e92.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.64%\"\u003e\n \u003cp\u003eMotor Vehicular Accident\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.92%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.76%\"\u003e\n \u003cp\u003e7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"613\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2. Surgery Statistics\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.965742251223492%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"83.03425774877651%\" colspan=\"6\"\u003e\n \u003cp\u003eType of Hip Prosthesis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"34.184675834970534%\" colspan=\"2\"\u003e\n \u003cp\u003eAustin-Moore (n=29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.381139489194496%\" colspan=\"2\"\u003e\n \u003cp\u003eThompson (n=49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.43418467583497%\" colspan=\"2\"\u003e\n \u003cp\u003eModular (n=14)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"17.125984251968504%\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.125984251968504%\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.125984251968504%\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.125984251968504%\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.125984251968504%\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.37007874015748%\"\u003e\n \u003cp\u003eSD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.99346405228758%\"\u003e\n \u003cp\u003eOperative time(minutes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e87.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e36.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e86.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e26.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e77.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.928104575163399%\"\u003e\n \u003cp\u003e18.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.99346405228758%\"\u003e\n \u003cp\u003eLength of stay (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e13.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e5.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e11.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e5.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e10.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.928104575163399%\"\u003e\n \u003cp\u003e3.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.99346405228758%\"\u003e\n \u003cp\u003eDays to surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e10.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e5.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e8.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e5.70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e7.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.928104575163399%\"\u003e\n \u003cp\u003e3.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.99346405228758%\"\u003e\n \u003cp\u003eThe time interval between surgery and discharge (days)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e3.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e1.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.215686274509803%\"\u003e\n \u003cp\u003e3.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.928104575163399%\"\u003e\n \u003cp\u003e.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"630\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 3. Charlson Comorbidity Score and Type of Hip Prosthesis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.380952380952381%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"87.61904761904762%\" colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Type of Hip Prosthesis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003eAustin-Moore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003eThompson\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003eModular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.304347826086957%\" valign=\"top\"\u003e\n \u003cp\u003eANOVA F-ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.043478260869565%\" valign=\"top\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.73913043478261%\" valign=\"top\"\u003e\n \u003cp\u003eInterpretation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.380952380952381%\" valign=\"top\"\u003e\n \u003cp\u003eMean (\u003cem\u003eSD\u003c/em\u003e) CCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e3.95 (\u003cem\u003e1.53)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e4.20 (\u003cem\u003e1.52\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e3.93 \u003cem\u003e(1.07\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.285714285714286%\" valign=\"top\"\u003e\n \u003cp\u003e.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.428571428571429%\" valign=\"top\"\u003e\n \u003cp\u003e.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.047619047619047%\" valign=\"top\"\u003e\n \u003cp\u003eNo Significant Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"780\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"9\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 4. Correlations Between Charlson Comorbidty Score, Operative Time, Blood Loss, Hospital Duration, Mortality Rate, and Ambulation Status.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003eCharslon Comorbidity Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003eOperative Time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003eEstimated Blood Loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003eLength of Hospital Stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003eDays to Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eDays Between Surgery and Discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003eCumulative Mortality Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eAmbulation Status\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eCharslon Comorbidty Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eOperative Time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e-.42*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eEstimated Blood Loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e-.25*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003e.48*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eLength of Hospital Stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e-.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003e-.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e.25*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eDays to Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e-.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003e-.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e.23*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e.98*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eDays Between Surgery and Discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e-.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e-.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003e-.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eCumulative Mortality Rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e-.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003e-.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e-.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003e-.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e-.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003eAmbulation Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.076923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e-.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10%\" valign=\"top\"\u003e\n \u003cp\u003e.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.76923076923077%\" valign=\"top\"\u003e\n \u003cp\u003e-.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.23076923076923%\" valign=\"top\"\u003e\n \u003cp\u003e.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.461538461538462%\" valign=\"top\"\u003e\n \u003cp\u003e-.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.538461538461538%\" valign=\"top\"\u003e\n \u003cp\u003e-.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.307692307692308%\" valign=\"top\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"762\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"7\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 5: One-Way ANOVA for Type of Prosthesis as Independent Variable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"44.56094364351245%\" colspan=\"3\"\u003e\n \u003cp\u003eM (\u003cem\u003eSD)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003eF-Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003eInterpretation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.154652686762779%\"\u003e\n \u003cp\u003eAustin-Moore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.5478374836173%\"\u003e\n \u003cp\u003eThompson\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.858453473132371%\"\u003e\n \u003cp\u003eModular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003eCCS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.154652686762779%\"\u003e\n \u003cp\u003e3.95 (\u003cem\u003e1.53)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.5478374836173%\"\u003e\n \u003cp\u003e4.20 (\u003cem\u003e1.52\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.858453473132371%\"\u003e\n \u003cp\u003e3.93 \u003cem\u003e(1.07\u003c/em\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003eNo Significant Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003eOperative Time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.154652686762779%\"\u003e\n \u003cp\u003e87.33 \u003cem\u003e(36.67)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.5478374836173%\"\u003e\n \u003cp\u003e86.54 \u003cem\u003e(26.27)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.858453473132371%\"\u003e\n \u003cp\u003e77.50 \u003cem\u003e(18.05)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003eNo Significant Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003eLength of Hospital Stay\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.154652686762779%\"\u003e\n \u003cp\u003e13.57 (\u003cem\u003e5.24)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.5478374836173%\"\u003e\n \u003cp\u003e11.83 \u003cem\u003e(5.47)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.858453473132371%\"\u003e\n \u003cp\u003e10.21 \u003cem\u003e(3.96)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e1.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003eNo Significant Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003eDays to Surgery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.154652686762779%\"\u003e\n \u003cp\u003e10.62 \u003cem\u003e(5.38)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.5478374836173%\"\u003e\n \u003cp\u003e8.61 \u003cem\u003e(5.70)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.858453473132371%\"\u003e\n \u003cp\u003e7.21 \u003cem\u003e(3.79)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e1.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003eNo Significant Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003eDays Between Surgery and Discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.154652686762779%\"\u003e\n \u003cp\u003e2.95 \u003cem\u003e(.97)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.5478374836173%\"\u003e\n \u003cp\u003e3.22 \u003cem\u003e(1.44)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.858453473132371%\"\u003e\n \u003cp\u003e3.00 \u003cem\u003e(.68)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003eNo Significant Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003eEstimated Blood Loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.154652686762779%\"\u003e\n \u003cp\u003e262.86 \u003cem\u003e(145.47)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.5478374836173%\"\u003e\n \u003cp\u003e206.75 \u003cem\u003e(99.62)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.858453473132371%\"\u003e\n \u003cp\u003e137.86 \u003cem\u003e(58.20)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e5.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003eSignificant Difference\u003c/p\u003e\n \u003cp\u003e(Austin-Moore significantly higher blood loss than Modular)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.416775884665793%\"\u003e\n \u003cp\u003eAmbulation Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.154652686762779%\"\u003e\n \u003cp\u003e3.29 \u003cem\u003e(1.01)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.5478374836173%\"\u003e\n \u003cp\u003e3.95 \u003cem\u003e(1.47)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.858453473132371%\"\u003e\n \u003cp\u003e4.07 \u003cem\u003e(1.27)\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e2.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.51900393184797%\"\u003e\n \u003cp\u003e.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.98427260812582%\"\u003e\n \u003cp\u003eNo Significant Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"762\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 6: Tukey\u0026rsquo;s Post-Hoc Test of Multiple Comparisons for Type of Prosthesis and Estimated Blood Loss\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.84796854521625%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"68.15203145478375%\" colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eMean Difference\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.88976377952756%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\" valign=\"top\"\u003e\n \u003cp\u003eAustin-Moore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\" valign=\"top\"\u003e\n \u003cp\u003eThompson\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\" valign=\"top\"\u003e\n \u003cp\u003eModular\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.88976377952756%\" valign=\"top\"\u003e\n \u003cp\u003eAustin-Moore\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.88976377952756%\" valign=\"top\"\u003e\n \u003cp\u003eThompson\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e56.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.88976377952756%\" valign=\"top\"\u003e\n \u003cp\u003eModular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e125.0*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e68.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.703412073490814%\"\u003e\n \u003cp\u003e---\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-orthopaedic-surgery-and-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"josr","sideBox":"Learn more about [Journal of Orthopaedic Surgery and Research](http://josr-online.biomedcentral.com)","snPcode":"13018","submissionUrl":"https://submission.nature.com/new-submission/13018/3","title":"Journal of Orthopaedic Surgery and Research","twitterHandle":"@MSKmedBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Charlson Co-morbidity Score, Monopolar Hip Prostheses, Femoral neck fractures","lastPublishedDoi":"10.21203/rs.3.rs-4793603/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4793603/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Hip fractures remain a significant healthcare problem worldwide, with an annual incidence of 1.7 million. Published literature regarding mortality and associated Charlson Co-morbidity score using Austin-Moore, Thompson, and Modular hip hemiarthroplasty in the Philippines is limited.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: This 5-year retrospective cohort study involved 92 elderly patients who underwent hip hemiarthroplasty using Austin-Moore, Thompson, or Modular hip prosthesis in the treatment of acute femoral neck fractures. A comprehensive chart review on admission and patient clinic follow-ups at 1-month, 6-months and 12-months after surgery was done. The objectives of the study included the demographic and clinical profiles, operative times, length of hospital stay, Charlson Comorbidity Score and mortality rate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The average age of patients with femoral neck fractures was 73 years old. Majority were females at 81.4%; Most injuries were secondary to fall at 91.3%, whereas 8.7% were due to vehicular accidents. Patients treated with Austin-Moore, Thompson, and Modular Hip prosthesis were 31.5%, 53.2%, and 15.2% respectively. The patients had an average length of hospitalization of 11 days, and an average CC score was 4.28. There was a significant difference in estimated blood loss across the different types of prosthesis, wherein, Austin-Moore prostheses were higher with a mean difference of 125 ml and p\u0026lt;.05. No significant differences were found regarding operative times, length of hospital stay, Charlson Comorbidity Score and mortality rates.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e. The mortality rates and associated Charlson Co-morbidity scores in patients with femoral neck fractures were comparable with published literatures. Using Austin-Moore, Thompson, and Modular hip prostheses in hip hemiarthroplasty is an effective treatment modality indicated for elderly patients with femoral neck fractures and high CCS.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTherapeutic Level: III\u003c/strong\u003e\u003c/p\u003e","manuscriptTitle":"Mortality Rate and Charlson Co-morbidity Scores of Patients with Femoral Neck Fractures Treated with Hip Hemiarthroplasty using Austin-Moore, Thompson, and Modular Hip Prostheses in a Tertiary Government Hospital","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-21 06:40:49","doi":"10.21203/rs.3.rs-4793603/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorAssigned","content":"","date":"2024-07-25T00:57:46+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-07-25T00:24:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Orthopaedic Surgery and Research","date":"2024-07-24T08:24:32+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-orthopaedic-surgery-and-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"josr","sideBox":"Learn more about [Journal of Orthopaedic Surgery and Research](http://josr-online.biomedcentral.com)","snPcode":"13018","submissionUrl":"https://submission.nature.com/new-submission/13018/3","title":"Journal of Orthopaedic Surgery and Research","twitterHandle":"@MSKmedBMC","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c1d86510-04ce-4481-ab7f-659b95428be3","owner":[],"postedDate":"August 21st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-08-21T06:40:49+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-21 06:40:49","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4793603","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4793603","identity":"rs-4793603","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}