Is it time to phase out the Austin moore hemiarthroplasty? A propensity score matched case control comparison versus cemented hemiarthroplasty

Abstract

We compared the Austin Moore hemiarthroplasty versus cemented hemiarthroplasties using a propensity score matched cased control study. For a consecutive cohort of 450 patients with displaced intracapsular neck of femur fractures, 128 matched cases in each group were selected based on age, gender, walking status, nursing home residency, delays in surgery, ASA score, and the Charlson comorbidity score. At a mean follow-up of 16.3 months, we evaluated their outcomes. Significantly more patients with AMA experienced thigh pain (RR = 3.5, 95% CI: 1.67-7.33, p = 0.000), overall complications (RR = 4.47, 95% CI: 1.77-11.3, p = 0.000), and implant loosening (RR = 8.42, 95% CI: 2.63-26.95, p = 0.000). There were no definite cement related deaths in this series. There was no significant difference in mortality, walking status, and the number of revisions between the groups. We support the routine use of cemented hemiarthroplasty instead of the Austin Moore for treating elderlies with displaced intracapsular neck of femur fractures.