The results of an international randomised controlled trial of patients with hip fracture challenge recent guidelines favouring total hip arthroplasty over hemiarthroplasty, researchers report.

Their study, conducted in 10 countries including Australia, found the type of arthroplasty used for previously ambulant patients with displaced fractures of the femoral neck made no difference to the likelihood of surgical revision after two years.

A secondary hip procedure was needed for 7.9% of total arthroplasty patients and 8.3% of hemiarthroplasty patients, a non-significant difference, the researchers found.

In the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemi-Arthroplasty (HEALTH) trial, almost 1500 patients from 80 centres were randomly assigned to either treatment, from January 2009 through May 2017, with follow-up in May 2019.