Shuichi Miyamoto1, Junichi Nakamura2, Satoshi Iida3, Tomonori Shigemura4, Shunji Kishida5, Isao Abe6, Munenori Takeshita7, Yoshitada Harada8, Sumihisa Orita2, Seiji Ohtori2. 1. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan. shuichi0220miyamoto@helen.ocn.ne.jp. 2. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan. 3. Matudo City Hospital, 4005 Kamihongou, Matudo City, Chiba, 271-8511, Japan. 4. Sanmu Medical Center, 167 Narutou, Sanmu City, Chiba, 289-1326, Japan. 5. Seirei Sakura Citizen Hospital, 2-36-2 Eharadai, Sakura City, Chiba, 285-8765, Japan. 6. National Hospital Organization Chiba Medical Center, 4-1-2 Tubakinomori, Chuo-ku, Chiba City, Chiba, 260-8606, Japan. 7. Kimitu Central Hospital, 1010 Sakurai, Kisarazu City, Chiba, 292-8535, Japan. 8. Saiseikai Narashino Hospital, 1-1-1 Izumichou, Narashino City, Chiba, 275-8580, Japan.
Abstract
INTRODUCTION: The purpose of this study was to compare the cemented bipolar hemiarthroplasty with uncemented about the change of intraoperative blood pressure and the incidence of major complications in elderly patients with femoral neck fracture. MATERIALS AND METHODS: This multiple center prospective cohort study included only patients with acute displaced femoral neck fracture (Garden stage III or IV). All patients were treated with cemented or uncemented bipolar hemiarthroplasty using modified Hardinge or Watson-Jones approach in the lateral decubitus position. Baseline data, medical history, type of anesthesia, FiO2 value, the number of vasopressor using during operation, femoral component, intraoperative blood pressure, SaO2, and major complications were evaluated. RESULTS: Of 164 patients (45 males and 119 females), 86 underwent cemented and 78 underwent uncemented bipolar hemiarthroplasty. Baseline medical histories were similar in both groups. In both the cemented and uncemented groups, intraoperative systolic blood pressure significantly decreased during cementing or rasping (106.3 and 103.6 mmHg) and after femoral component insertion (103.3 and 99.1 mmHg) compared to before rasping (120.7 and 116.4 mmHg) (p < 0.0001, respectively). Donaldson's grade seemed more favorable in uncemented group than in cemented group during cementing or rasping, during stem insertion; however, no patients experienced the lethal complication in both groups. CONCLUSIONS: Intraoperative blood pressure did not change during cemented and uncemented bipolar hemiarthrplasty for displaced femoral neck fracture. If the standard modern cement technique was performed during operation, bone cement is a safe and acceptable for elderly patients who have a lot of medical histories.
INTRODUCTION: The purpose of this study was to compare the cemented bipolar hemiarthroplasty with uncemented about the change of intraoperative blood pressure and the incidence of major complications in elderly patients with femoral neck fracture. MATERIALS AND METHODS: This multiple center prospective cohort study included only patients with acute displaced femoral neck fracture (Garden stage III or IV). All patients were treated with cemented or uncemented bipolar hemiarthroplasty using modified Hardinge or Watson-Jones approach in the lateral decubitus position. Baseline data, medical history, type of anesthesia, FiO2 value, the number of vasopressor using during operation, femoral component, intraoperative blood pressure, SaO2, and major complications were evaluated. RESULTS: Of 164 patients (45 males and 119 females), 86 underwent cemented and 78 underwent uncemented bipolar hemiarthroplasty. Baseline medical histories were similar in both groups. In both the cemented and uncemented groups, intraoperative systolic blood pressure significantly decreased during cementing or rasping (106.3 and 103.6 mmHg) and after femoral component insertion (103.3 and 99.1 mmHg) compared to before rasping (120.7 and 116.4 mmHg) (p < 0.0001, respectively). Donaldson's grade seemed more favorable in uncemented group than in cemented group during cementing or rasping, during stem insertion; however, no patients experienced the lethal complication in both groups. CONCLUSIONS: Intraoperative blood pressure did not change during cemented and uncemented bipolar hemiarthrplasty for displaced femoral neck fracture. If the standard modern cement technique was performed during operation, bone cement is a safe and acceptable for elderly patients who have a lot of medical histories.
Authors: Adam I Edelstein; Eric L Hume; Liliana E Pezzin; Emily L McGinley; Timothy R Dillingham Journal: J Bone Joint Surg Am Date: 2022-03-16 Impact factor: 5.284