B Barenius1, C Inngul1, Z Alagic2, A Enocson3. 1. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Unit of Orthopaedics, Stockholm South General Hospital, Stockholm, Sweden. 2. Department of Molecular Medicine and Surgery, Unit of Diagnostic Radiology, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden. 3. Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Unit of Orthopaedics, Stockholm South General Hospital, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Unit of Orthopaedics, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
Abstract
Aims: The aim of this study was to compare the functional and radiological outcomes in patients with a displaced fracture of the hip who were treated with a cemented or a cementless femoral stem. Patients and Methods: A four-year follow-up of a randomized controlled study included 141 patients who underwent surgery for a displaced femoral neck fracture. Patients were randomized to receive either a cemented (n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA; n = 83) or total hip arthroplasty (THA; n = 58). Results: Early differences in functional outcome, assessed using the Harris Hip Score, the Short Musculoskeletal Functional Assessment score and EuroQol-5D, with better results in cemented group, deteriorated over time and there were no statistically significant differences at 48 months. Two (3%) patients in the cemented group and five (6.8%) in the cementless group underwent further surgery for a periprosthetic fracture. This difference was statistically significant (p = 0.4). No patient underwent further surgery for instability or infection between one and four years postoperatively. The mortality and the radiological outcomes were similar in both groups. Conclusion:Patients with a displaced femoral neck fracture treated with anarthroplasty using a cemented or cementless stem had good function and few complications up to four years postoperatively. However, due to the poor short-term functional outcomes in the cementless group, the findings do not support their routine use in the treatment of these elderly patients. Cite this article: Bone Joint J 2018;100-B:1087-93.
RCT Entities:
Aims: The aim of this study was to compare the functional and radiological outcomes in patients with a displaced fracture of the hip who were treated with a cemented or a cementless femoral stem. Patients and Methods: A four-year follow-up of a randomized controlled study included 141 patients who underwent surgery for a displaced femoral neck fracture. Patients were randomized to receive either a cemented (n = 67) or a cementless (n = 74) stem at hemiarthroplasty (HA; n = 83) or total hip arthroplasty (THA; n = 58). Results: Early differences in functional outcome, assessed using the Harris Hip Score, the Short Musculoskeletal Functional Assessment score and EuroQol-5D, with better results in cemented group, deteriorated over time and there were no statistically significant differences at 48 months. Two (3%) patients in the cemented group and five (6.8%) in the cementless group underwent further surgery for a periprosthetic fracture. This difference was statistically significant (p = 0.4). No patient underwent further surgery for instability or infection between one and four years postoperatively. The mortality and the radiological outcomes were similar in both groups. Conclusion:Patients with a displaced femoral neck fracture treated with an arthroplasty using a cemented or cementless stem had good function and few complications up to four years postoperatively. However, due to the poor short-term functional outcomes in the cementless group, the findings do not support their routine use in the treatment of these elderly patients. Cite this article: Bone Joint J 2018;100-B:1087-93.
Entities:
Keywords:
Cemented; Cementless; Femoral neck fracture; Hemiarthroplasty hip; Total hip arthroplasty
Authors: Sharon R Lewis; Richard Macey; Jamie Stokes; Jonathan A Cook; William Gp Eardley; Xavier L Griffin Journal: Cochrane Database Syst Rev Date: 2022-02-14
Authors: Marianne Comeau-Gauthier; Robert D Zura; Sofia Bzovsky; Emil H Schemitsch; Daniel Axelrod; Victoria Avram; Ajay Manjoo; Rudolf W Poolman; Frede Frihagen; Diane Heels-Ansdell; Mohit Bhandari; Sheila Sprague Journal: J Bone Joint Surg Am Date: 2021-07-21 Impact factor: 6.558