Changes in Rehabilitation Outcomes by new Guidelines of Hong Kong Hospital Authority in Implant Choice for Femoral Neck Fractures—Austin Moore versus Cemented Exeter Hemiarthroplasty

Abstract

Background In 2013, Hospital Authority of Hong Kong replaced Austin Moore Arthroplasty (AMA) with cemented Exeter hemiarthroplasty for displaced femoral neck fractures. This study evaluated whether this new guidelines resulted in better mortality, hospital service reattendances and rehabilitation outcomes. Methods Patients aged 65–84 years with hemiarthroplasty done in a tertiary hospital during 2012–2014 were reviewed retrospectively. AMA group included AMAs carried out during years 2012–2013, and Exeter group included cemented modular Exeter hemiarthroplasties carried out during years 2013–2014. All patients were followed-up for 2 years. Results The Exeter group performed significantly better in rehabilitation outcomes than AMA group in terms of mobility score, independent and outdoor walking and community dwelling. They also had less hospital service reattendances due to falls, refractures and implant-related causes. There was a trend towards lower mortality in the Exeter group with increasing duration from operation. Conclusion The new guidelines in replacing AMA with cemented Exeter hemiarthroplasty resulted in better patient outcomes.