{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T02:42:16Z","timestamp":1781664136955,"version":"3.54.5"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Geriatr Orthop Surg Rehabil"],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Hemiarthroplasty is increasingly used for the treatment of geriatric femoral neck fractures in an effort to optimize value-based care. The current American Association of Orthopaedic Surgeons (AAOS) guidelines released in 2014 for the treatment of geriatric hip fractures recommend the utilization of monopolar cemented constructs. The purpose of this study was to evaluate hip hemiarthroplasty implant cost variability and implant selection trends from 2006 to 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A retrospective review of 940 geriatric hip fractures treated with hemiarthroplasty was conducted across 3 institutions from 2006 to 2018. Variables examined were construct type, surgeon, operative time, patient mortality, and implant cost. Statistical analysis consisted of multigroup comparative tests and multiple linear regression analyses to evaluate correlative measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study population was 85.0 \u00b1 7.9 years of age with a body mass index of 24.0 \u00b1 5.5. A total of 33 (3.5%) patients were deceased at the 90-day postoperative mark and 45 (4.8%) patients at the 1-year mark. There was no statistical difference in terms of mortality between the 4 implant cohorts at the 90-day mark ( P = .56) and 1-year mark ( P = .24). The bipolar press-fit construct was the most expensive, US$3900.61 \u00b1 US$2607.54, and the monopolar cemented construct was the least expensive, US$2618.68 \u00b1 US$1834.16. The mean operative time was 6 minutes greater for press-fit implants, 93.6 \u00b1 32.0, than cemented implants, 87.1 \u00b1 33.6 ( P = .02). The use of monopolar cemented implants increased from 12.1% to 83.3%, while bipolar press-fit decreased from 57.6% to 4.6% from 2013 to 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>The use of a bipolar and\/or press-fit implant significantly increases construct cost despite little evidence in the literature of improved outcomes. Contrary to previous research, cemented implants do not increase the operative time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Encouragingly, selection of the most cost-conscience implant, monopolar cemented, has been increasing since 2014, which may reflect the influence of current AAOS guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Diagnostic Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2151459320927378","type":"journal-article","created":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T08:31:33Z","timestamp":1591777893000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Geriatric Femoral Neck Fractures: Hemiarthroplasty Implant Trends Across a Health System From 2006 to 2018"],"prefix":"10.1177","volume":"11","author":[{"given":"Kendra","family":"Kibble","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah C.","family":"Peck","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh R.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA"},{"name":"Department of Orthopaedic Surgery, Regions Hospital, Saint Paul, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilexa","family":"Flagstad","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Gorman","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Bandele","family":"Okelana","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6653-2451","authenticated-orcid":false,"given":"Brian P.","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Methodist Hospital, St. Louis Park, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,6,10]]},"reference":[{"key":"bibr1-2151459320927378","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.01247"},{"key":"bibr2-2151459320927378","unstructured":"US Census Bureau. 2017. National Population Projections Tables: Main Series. https:\/\/www.census.gov\/data\/tables\/2017\/demo\/popproj\/2017-summary-tables.html. Accessed September 22, 2019."},{"key":"bibr3-2151459320927378","unstructured":"American Association of Orthopaedic Surgeons. Management of hip fractures in the elderly summary. Am Acad Orthop Surg. 2014;(September). https:\/\/www.aaos.org\/cc_files\/aaosorg\/research\/guidelines\/hipfxsummaryofrecommendations.pdf. Accessed September 22, 2019."},{"key":"bibr4-2151459320927378","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.1627"},{"key":"bibr5-2151459320927378","author":"American Association of Orthopaedic Surgeons","year":"2009","journal-title":"Am Acad Orthop Surg"},{"key":"bibr6-2151459320927378","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-015-0165-0"},{"key":"bibr7-2151459320927378","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12048"},{"key":"bibr8-2151459320927378","doi-asserted-by":"crossref","unstructured":"Kenzora JE, Magaziner J, Hudson J, et al. Outcome after hemiarthroplasty for femoral neck fractures in the elderly. Clin Orthop Relat Res. 1998;(348):51\u201358. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/9553533. Accessed September 22, 2019.","DOI":"10.1097\/00003086-199803000-00010"},{"key":"bibr9-2151459320927378","doi-asserted-by":"crossref","unstructured":"Cornell CN, Levine D, O\u2019Doherty J, Lyden J. Unipolar versus bipolar hemiarthroplasty for the treatment of femoral neck fractures in the elderly. Clin Orthop Relat Res. 1998;(348):67\u201371. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/9553535. Accessed September 22, 2019.","DOI":"10.1097\/00003086-199803000-00012"},{"key":"bibr10-2151459320927378","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2009.05040.x"},{"key":"bibr11-2151459320927378","doi-asserted-by":"publisher","DOI":"10.1177\/1120700019832989"},{"key":"bibr12-2151459320927378","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.00355"},{"key":"bibr13-2151459320927378","doi-asserted-by":"publisher","DOI":"10.1016\/S0883-5403(96)80025-8"},{"key":"bibr14-2151459320927378","unstructured":"Liu TC, Sambare T, Keshwani A, Bozic KJ, Koenig KM. Surgeons use additional strategies to improve the value of hip fracture care. AAOS Now. 2017;(Dec). https:\/\/www.aaos.org\/aaosnow\/search\/?Subspecialties=Hip&Issue_h=December%202017. Accessed September 22, 2019."},{"key":"bibr15-2151459320927378","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000014634"},{"key":"bibr16-2151459320927378","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.79879"},{"key":"bibr17-2151459320927378","doi-asserted-by":"crossref","unstructured":"Chen SC, Badrinath K, Pell LH, Mitchell K. The movements of the components of the Hastings bipolar prosthesis. A radiographic study in 65 patients. J Bone Joint Surg Br. 1989;71(2):186\u2013188. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/2925732. Accessed September 22, 2019.","DOI":"10.1302\/0301-620X.71B2.2925732"},{"key":"bibr18-2151459320927378","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-198912000-00010"},{"key":"bibr19-2151459320927378","doi-asserted-by":"crossref","unstructured":"Phillips TW. The Bateman bipolar femoral head replacement. A fluoroscopic study of movement over a four-year period. J Bone Joint Surg Br. 1987;69(5):761\u2013764. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/3680337. 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