Factors associated with selection of total hip arthroplasty versus hemiarthroplasty for femoral neck…

Cohort studyArchives of orthopaedic and trauma surgery· Aug 2026

Factors associated with selection of total hip arthroplasty versus hemiarthroplasty for femoral neck fracture in older adults: a nationwide analysis of 99,084 cases.

David Maman, Yaniv Steinfield, Yaron Berkovich

ArthroplastyCohort studyDiagnosisQ1IF 2.8

Alzheimer's disease was associated with markedly lower odds of receiving total hip arthroplasty.

Factors associated with selection of total hip arthroplasty versus hemiarthroplasty for femoral neck fracture in older adults: a nationwide analysis of 99,084 cases.

David Maman … Yaron Berkovich

Archives of orthopaedic and trauma surgery · Aug 2026 · Q1 in Orthopedics

Background

Surgical management of displaced femoral neck fractures in older adults typically involves hemiarthroplasty or total hip arthroplasty (total hip arthroplasty).

Purpose

This study evaluated patient factors associated with selection of total hip arthroplasty versus hemiarthroplasty in a contemporary U.

Methods

Patients ≥ 65 years hospitalized with femoral neck fracture were identified using ICD-10-CM codes.

n = 99,084 cases

Results

alzheimer's patients had far lower odds of getting a full hip replacement

81.8%

Hemiarthroplasty

18.2%

THA

More results

Among 142,013 operative cases, 99,084 met inclusion criteria (81.8% hemiarthroplasty; 18.2% total hip arthroplasty).

Metabolic conditions were associated with increased odds of total hip arthroplasty, including obesity (OR 1.17) and sleep apnea (OR 1.12).

More results

Each additional year of age decreased the odds of total hip arthroplasty by approximately 9%.

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Conclusion

In this nationwide cohort, selection of total hip arthroplasty rather than hemiarthroplasty was associated with younger age and lower prevalence of frailty- and cognition-related comorbidities, while several metabolic comorbidities showed modest positive associations with total hip arthroplasty use.

Factors associated with selection of total hip arthroplasty versus hemiarthroplasty for femoral neck fracture in older adults: a nationwide analysis of 99,084 cases.

Factors associated with selection of total hip arthroplasty versus hemiarthroplasty for femoral neck fracture in older adults: a nationwide analysis of 99,084 cases.

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