M R M Frenken1, M G M Schotanus2, E H van Haaren3, R Hendrickx3. 1. Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands. 2. Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands. martijnschotanus@hotmail.com. 3. Department of Orthopaedic Surgery and Traumatology, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands.
Abstract
PURPOSE: We wished to compare the outcome of two types of cemented and uncemented modern stem design implants after hemiarthroplasty, with both an Orthopaedic Data Evaluation Panel rating of 10A. METHODS: This retrospective study compares data obtained from two centres, with a total study population of 655 (n = 393 cemented, n = 262 uncemented). Patients were matched at baseline for gender, age, surgery side, American Society of Anesthesiologists score, body mass index and pre-operative haemoglobin level. Outcome measurements were prosthesis-related complications, pre- and post-operative, with reoperation rate and mortality and other complications after 1 year, surgery time, blood loss and immobility at discharge. RESULTS: There were no significant differences in mortality after 1 year, total other complications, immobility at the time of discharge and total prosthesis-related complications between both groups. Significantly more periprosthetic fractures and post-operative infections were seen in the uncemented group with significantly more reoperations compared to the cemented group. Significant differences were seen in cardiovascular complications, blood loss and surgery time in favour of the uncemented group. CONCLUSIONS: In consequence of the significant higher prosthesis-related complications (e.g. infections, periprosthetic fractures and reoperations) in the uncemented group in this study, we recommend cemented hemiarthroplasty in patients with a femoral neck fracture. LEVEL OF EVIDENCE: Level III, Case Controlled Study.
PURPOSE: We wished to compare the outcome of two types of cemented and uncemented modern stem design implants after hemiarthroplasty, with both an Orthopaedic Data Evaluation Panel rating of 10A. METHODS: This retrospective study compares data obtained from two centres, with a total study population of 655 (n = 393 cemented, n = 262 uncemented). Patients were matched at baseline for gender, age, surgery side, American Society of Anesthesiologists score, body mass index and pre-operative haemoglobin level. Outcome measurements were prosthesis-related complications, pre- and post-operative, with reoperation rate and mortality and other complications after 1 year, surgery time, blood loss and immobility at discharge. RESULTS: There were no significant differences in mortality after 1 year, total other complications, immobility at the time of discharge and total prosthesis-related complications between both groups. Significantly more periprosthetic fractures and post-operative infections were seen in the uncemented group with significantly more reoperations compared to the cemented group. Significant differences were seen in cardiovascular complications, blood loss and surgery time in favour of the uncemented group. CONCLUSIONS: In consequence of the significant higher prosthesis-related complications (e.g. infections, periprosthetic fractures and reoperations) in the uncemented group in this study, we recommend cemented hemiarthroplasty in patients with a femoral neck fracture. LEVEL OF EVIDENCE: Level III, Case Controlled Study.
Entities:
Keywords:
Cemented; Femoral neck fracture; Hemiarthroplasty; Hip replacement arthroplasty; Uncemented
Authors: P T P W Burgers; M Hoogendoorn; E A C Van Woensel; R W Poolman; M Bhandari; P Patka; E M M Van Lieshout Journal: Osteoporos Int Date: 2016-01-28 Impact factor: 4.507