Are there patients with an intracapsular fracture of the hip who may benefit from an uncemented hemiarthroplasty?
Journal
The bone & joint journal
ISSN: 2049-4408
Titre abrégé: Bone Joint J
Pays: England
ID NLM: 101599229
Informations de publication
Date de publication:
01 Jul 2024
01 Jul 2024
Historique:
medline:
1
7
2024
pubmed:
1
7
2024
entrez:
30
6
2024
Statut:
epublish
Résumé
Cemented hemiarthroplasty is an effective form of treatment for most patients with an intracapsular fracture of the hip. However, it remains unclear whether there are subgroups of patients who may benefit from the alternative operation of a modern uncemented hemiarthroplasty - the aim of this study was to investigate this issue. Knowledge about the heterogeneity of treatment effects is important for surgeons in order to target operations towards specific subgroups who would benefit the most. We used causal forest analysis to compare subgroup- and individual-level treatment effects between cemented and modern uncemented hemiarthroplasty in patients aged > 60 years with an intracapsular fracture of the hip, using data from the World Hip Trauma Evaluation 5 (WHiTE 5) multicentre randomized clinical trial. EuroQol five-dimension index scores were used to measure health-related quality of life at one, four, and 12 months postoperatively. Our analysis revealed a complex landscape of responses to the use of a cemented hemiarthroplasty in the 12 months after surgery. There was heterogeneity of effects with regard to baseline characteristics, including age, pre-injury health status, and lifestyle factors such as alcohol consumption. This heterogeneity was greater at the one-month mark than at subsequent follow-up timepoints, with particular regard to subgroups based on age. However, for all subgroups, the effect estimates for quality of life lay within the confidence intervals derived from the analysis of all patients. The use of a cemented hemiarthroplasty is expected to increase health-related quality of life compared with modern uncemented hemiarthroplasty for all subgroups of patients aged > 60 years with a displaced intracapsular fracture of the hip.
Identifiants
pubmed: 38945545
doi: 10.1302/0301-620X.106B7.BJJ-2024-0267
pii: BJJ-2024-0267
doi:
Substances chimiques
Bone Cements
0
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
656-661Informations de copyright
© 2024 Bolbocean et al.
Déclaration de conflit d'intérêts
M. L. Costa reports funding for the WHiTE 5 trial from the NIHR to University of Oxford, related to this study.
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