Displaced Hip Fractures: Treatment

Description

This transcript features an informative discussion by Matthew Costa about the evolving approaches to treating displaced intracapsular hip fractures, particularly focusing on the comparison between total hip replacement and hemiarthroplasty. Costa highlights recent changes in clinical practice over the past few years, indicating that the current NICE guidelines may not fully represent the latest evidence. He discusses the implications of the HEALTH trial, which suggested that the functional benefits of total hip replacement may not be as significant as previously thought, paving the way for cemented arthroplasty as a preferred option for many patients.



He identifies younger patients as a group that may still benefit from internal fixation due to their activity levels. Costa emphasizes the importance of making informed decisions based on patient demographics and fracture patterns, while also addressing the risks and benefits associated with using bone cement during surgeries. He shares insights from the WHiTE 5 trial, arguing for cemented hemiarthroplasty as a safer and more cost-effective intervention compared to uncemented options. Ultimately, he reassures practitioners about the overall benefits of cemented procedures despite acknowledging a slight increase in perioperative mortality risk.

DOI: 10.1302/3114-251097

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