Hemiparesis increases the risk of femoral neck fracture (FNF) in the elderly, which frequently necessitates hemiarthroplasty. There are limited reports on the outcomes of hemiarthroplasty in patients who have hemiparesis. Consequently, the purpose of this study was to evaluate hemiparesis as a potential risk factor for medical and surgical complications following hemiarthroplasty.
Hemiparetic patients who have concomitant FNF and underwent hemiarthroplasty with at least 2 years of follow-up were identified using a national insurance database. A 10:1 matched control cohort of patients who did not have hemiparesis was created for comparison. There were 1,340 patients who have and 12,988 patients who did not have hemiparesis undergoing hemiarthroplasty for FNF identified. Multivariate logistic regression analyses were used to evaluate rates of medical complications, surgical complications including revision, emergency department (ED)-visits, and hospital readmissions between the two cohorts.
Aside from increased rates of medical complications including cerebrovascular accident (P < 0.001), urinary tract infection (P = 0.020), sepsis (P = 0.002), and myocardial infection (P < 0.001) observed in patients who have hemiparesis, they also experienced higher rates of dislocation within 1 and 2 years (Odds Ratio (OR) 1.54, P = 0.009; OR 1.52, P =0.010). Hemiparesis was not associated with higher risk of wound complications, periprosthetic joint infection, aseptic loosening, and periprosthetic fracture, but was associated with higher incidence of 90-day ED-visits (OR 1.16, P = 0.031) and 90-day readmission (OR 1.32, P < 0.001).
While patients who have hemiparesis do not have increased risk of implant-related complications other than dislocation, they are still at increased risk of developing medical complications following hemiarthroplasty for FNF and subsequently may require more resources.

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