Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures?
نویسندگان
چکیده
BACKGROUND AND PURPOSE Cemented hemiarthroplasty is preferred in treating displaced fractures of the femoral neck in the elderly. The cementing process may cause a fat embolism, leading to serious complications or death. In this study, we wanted to determine whether use of uncemented hemiarthroplasty (HA) would lead to reduced mortality and whether there are differences in the complications associated with these different types of arthroplasty. PATIENTS AND METHODS From the PERFECT database, which combines information from various treatment registries, we identified 25,174 patients who were treated with hemiarthroplasty for a femoral neck fracture in the years 1999-2009. The primary outcome was mortality. Secondary outcomes were reoperations, complications, re-admissions, and treatment times. RESULTS Mortality was lower in the first postoperative days when uncemented HA was used. At 1 week, there was no significant difference in mortality (3.9% for cemented HA and 3.4% for uncemented HA; p = 0.09). This was also true after one year (26% for cemented HA and 27% for uncemented HA; p = 0.1). In patients treated with uncemented HA, there were significantly more mechanical complications (3.7% vs. 2.8%; p < 0.001), hip re-arthroplasties (1.7% vs. 0.95; p < 0.001), and femoral fracture operations (1.2% vs. 0.52%; p < 0.001) during the first 90 days after hip fracture surgery. INTERPRETATION From registry data, mortality appears to be similar for cemented and uncemented HA. However, uncemented HA is associated with more frequent mechanical complications and reoperations.
منابع مشابه
More complications in uncemented compared to cemented hemiarthroplasty for displaced femoral neck fractures: a randomized controlled trial of 201 patients, with one year follow-up
BACKGROUND It is unclear whether cemented or uncemented hemiarthroplasty is the best treatment option in elderly patients with displaced femoral neck fractures. Previous randomized trials comparing cemented and uncemented hemiarthroplasty have conflicting results. We conducted a randomized controlled trial to compare cemented and uncemented hemiarthroplasty. METHODS This multicenter parallel-...
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This retrospective study was undertaken to analyze perioperative parameters, functional outcomes and complications of cemented versus uncemented bipolar hemiarthroplasty in elderly patients presenting with displaced intracapsular femoral neck fracture. The authors reviewed 17 patients that underwent cemented bipolar hemiarthroplasty and 21 patients that underwent uncemented bipolar hemiarthropl...
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BACKGROUND AND PURPOSE Elderly patients with displaced femoral neck fractures are commonly treated with a hemiarthroplasty (HA), but little is known about the long-term failure of this treatment. We compared reoperation rates for patients aged at least 75 years with displaced femoral neck fractures treated with either internal fixation (IF), cemented HA, or uncemented HA (with or without hydrox...
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OBJECTIVE Controversy still exists regarding using cemented or uncemented hemiarthroplasty for femoral neck fractures in elderly patients. The aim of this study is to compare the effectiveness and safety of the two surgical techniques in femoral neck fracture patients over 70 years old. METHODS We searched PUBMED, EMBASE, Cochrane Library, CNKI and VIP Database from inception to December 2012...
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