Cemented versus uncemented hemiarthroplasty of the hip in patients with a femoral neck fracture: a comparison of two modern stem design implants

• Published in: European journal of orthopaedic surgery & traumatology Vol. 28; no. 7; pp. 1305 - 1312
• Main Authors: Frenken, M. R. M., Schotanus, M. G. M., van Haaren, E. H., Hendrickx, R.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.10.2018; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Anesthesia; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - methods; Body mass index; Bone Cements - therapeutic use; Cementation; Female; Femoral Neck Fractures - surgery; Fractures; Hemiarthroplasty - adverse effects; Hemiarthroplasty - methods; Hemoglobin; Hip Prosthesis - adverse effects; Hospitals; Humans; Joint surgery; Male; Medicine; Medicine & Public Health; Mortality; Original Article • HIP - ARTHROPLASTY; Postoperative Complications; Prostheses; Retrospective Studies; Surgery; Surgical Orthopedics; Transplants & implants; Traumatic Surgery; Treatment Outcome; Femoral neck fracture; Hip replacement arthroplasty; Cemented; Hemiarthroplasty; Uncemented
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-018-2202-2

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.