OBJECTIVE: To prospectively compare the functional outcome associated with cemented and uncemented hemiarthroplasty. DESIGN: Prospective randomized control trial. SETTING: University-affiliated level 1 trauma center. PATIENTS/PARTICIPANTS: All individuals designated for hemiarthroplasty, older than 55 years, with a nonpathologic displaced femoral neck fracture and the ability to ambulate 10 feet independently before injury [269 patients (274 hips) presented with displaced femoral neck fracture, 130 patients (48.3%) enrolled, and 5 patients (3.8%) withdrew]. INTERVENTION: Hip hemiarthroplasty with a cemented femoral prosthesis (VerSys LD/Fx; Zimmer, Warsaw, IN) or an uncemented component (VerSys Beaded FullCoat; Zimmer, Warsaw, IN). MAIN OUTCOME MEASURES: Instrumental Activities of Daily Living and Physical Activities of Daily Living scales (Older Americans Resources and Services Instrument) and the Energy/Fatigue Scale. RESULTS: No statistically significant differences were present in the groups' preoperative or intraoperative characteristics, including American Society of Anesthesiologists grade, operative time, anesthesia time, use of perioperative β-blockers, estimated blood loss, or the rate of intraoperative fracture. Postoperatively, no difference was found in hemoglobin level, transfusion rate, discharge disposition, or acute complication rate. At 30-day, 60-day, and 1-year follow-ups, no clinically or statistically significant differences were found in mortality, disposition, need for assistance with ambulation, Older Americans Resources and Services Activities of Daily Living subscales, or the Energy/Fatigue Scale. CONCLUSIONS: In the treatment of nonpathologic displaced femoral neck fractures, the use of cemented and uncemented femoral components is associated with similar functional outcome at 1 year. Practitioners may inform their clinical decisions using these equally good results. LEVEL OF EVIDENCE: Therapeutic Level II. See page 128 for a complete description of levels of evidence.
RCT Entities:
OBJECTIVE: To prospectively compare the functional outcome associated with cemented and uncemented hemiarthroplasty. DESIGN: Prospective randomized control trial. SETTING: University-affiliated level 1 trauma center. PATIENTS/PARTICIPANTS: All individuals designated for hemiarthroplasty, older than 55 years, with a nonpathologic displaced femoral neck fracture and the ability to ambulate 10 feet independently before injury [269 patients (274 hips) presented with displaced femoral neck fracture, 130 patients (48.3%) enrolled, and 5 patients (3.8%) withdrew]. INTERVENTION: Hip hemiarthroplasty with a cemented femoral prosthesis (VerSys LD/Fx; Zimmer, Warsaw, IN) or an uncemented component (VerSys Beaded FullCoat; Zimmer, Warsaw, IN). MAIN OUTCOME MEASURES: Instrumental Activities of Daily Living and Physical Activities of Daily Living scales (Older Americans Resources and Services Instrument) and the Energy/Fatigue Scale. RESULTS: No statistically significant differences were present in the groups' preoperative or intraoperative characteristics, including American Society of Anesthesiologists grade, operative time, anesthesia time, use of perioperative β-blockers, estimated blood loss, or the rate of intraoperative fracture. Postoperatively, no difference was found in hemoglobin level, transfusion rate, discharge disposition, or acute complication rate. At 30-day, 60-day, and 1-year follow-ups, no clinically or statistically significant differences were found in mortality, disposition, need for assistance with ambulation, Older Americans Resources and Services Activities of Daily Living subscales, or the Energy/Fatigue Scale. CONCLUSIONS: In the treatment of nonpathologic displaced femoral neck fractures, the use of cemented and uncemented femoral components is associated with similar functional outcome at 1 year. Practitioners may inform their clinical decisions using these equally good results. LEVEL OF EVIDENCE: Therapeutic Level II. See page 128 for a complete description of levels of evidence.
Authors: Ernst J Müller; Ingeborg Gerstorfer; Peter Dovjak; Bernhard Iglseder; Georg Pinter; Walter Müller; Katharina Pils; Peter Mikosch; Michaela Zmaritz; Monique Weissenberger-Leduc; Markus Gosch; Heinrich W Thaler Journal: Wien Med Wochenschr Date: 2013-11-08
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