Outcomes of Uncemented Hemiarthroplasty for Intracapsular Femoral Neck Fracture: A Retrospective Comparison of Trauma Fellowship-Trained Orthopaedists and Chief Resident Surgeons.

BACKGROUND

The purpose of this study was to evaluate the influence of primary surgeon fellowship training on the outcomes of uncemented hemiarthroplasty for femoral neck fractures with emphasis on intraoperative and postoperative complications.

METHODS

This was a retrospective comparative cohort study of patients who underwent uncemented hemiarthroplasty for intracapsular femoral neck fractures from 2010 to 2024 at a single institution. The study cohorts were defined according to whether the primary surgeon was a trauma fellowship-trained orthopaedist or a nonfellowship-trained chief (PGY-5) orthopaedic resident. Demographic, operative, and complication data were extracted from the medical records of patients meeting study eligibility criteria and were compiled in an electronic database. Categorical data were compared using chi-square or Fisher's Exact tests, whereas continuous variables were compared using Mann-Whitney U tests for skewed data.

RESULTS

A total of 395 patients were studied, 130 (32.9%) operated on by trauma fellowship-trained surgeons and 265 (67.1%) by non-trauma fellowship-trained chief orthopaedic surgery residents. There were no statistically significant differences between groups for intraoperative calcar fracture, postoperative infection, implant dislocation, or reoperation. Although patient survival at final follow-up was significantly higher in the fellowship-trained group, this result is likely multifactorial and should be interpreted with caution.

CONCLUSION

Uncemented hemiarthroplasty was associated with low complication rates regardless of surgeon fellowship training status. Our findings suggest that uncemented hemiarthroplasty can be safely and effectively performed by both trauma fellowship-trained orthopaedists and non-fellowship-trained chief orthopaedic surgery residents.

LEVEL OF EVIDENCE: III.