A Comparative Study of Functional Outcomes in Patients with Proximal Femur Fractures Treated with Total Hip Arthroplasty vs. Hemiarthroplasty

Abstract

Background: Proximal femur fractures are a common and debilitating injury, particularly among the elderly. The choice between Total Hip Arthroplasty (THA) and Hemiarthroplasty (HA) significantly impacts the patient's functional recovery, mobility, pain management, and overall quality of life. Objectives: This study aims to compare the functional outcomes, postoperative mobility, pain levels, and long-term patient satisfaction between THA and HA in treating proximal femur fractures. Methods: A retrospective cohort study was conducted with a sample size of 120 patients, equally divided between THA and HA groups. The functional outcomes were assessed using the Harris Hip Score and Oxford Hip Score, while mobility was evaluated through Activities of Daily Living (ADL) scores and walking speed. Pain levels were measured using the Visual Analog Scale, and long-term satisfaction was assessed through SF-36 and EQ-5D scores. Statistical significance was determined using t-tests and chi-square tests where appropriate. Results: The THA group showed significantly higher functional scores, including mean Harris Hip Score (82.3 vs. 79.1, p=0.043) and Oxford Hip Score (84.0 vs. 80.2, p=0.043). Mobility assessments also favored THA with higher ADL scores (8.7 vs. 8.0, p=0.017) and faster walking speeds (1.2 m/s vs. 1.0 m/s, p=0.017). Pain levels were lower in the THA group (VAS score: 3.0 vs. 3.7, p=0.029), and reoperation rates were significantly reduced (5.8% vs. 10%, p=0.029). Long-term satisfaction measures were also superior in the THA group (SF-36: 75.0 vs. 70.3, EQ-5D: 0.82 vs. 0.77, both p=0.018). Conclusion: Total Hip Arthroplasty is superior to Hemiarthroplasty in improving functional outcomes, enhancing mobility, reducing pain, and increasing long-term patient satisfaction in the treatment of proximal femur fractures. These findings suggest that THA should be considered the preferred surgical intervention in suitable patients.