Cemented versus uncemented hemiarthroplasty of the hip in patients with a femoral neck fracture: a comparison of two modern stem design implants
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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.
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.
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.
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.
KeywordsFemoral neck fracture Hemiarthroplasty Hip replacement arthroplasty Cemented Uncemented
Compliance with ethical standards
Conflict of interest
MRM Frenken, MGM Schotanus, EH van Haaren and R Hendrickx declare that they have no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangements) that might pose a conflict of interest in connection with the submitted manuscript.
- 4.Burgers PTPW, Hoogendoorn MV et al (2016) Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study, on behalf of the HEALTH trial investigators. Osteoporos Int 27:1999–2008CrossRefPubMedPubMedCentralGoogle Scholar
- 6.Nederlandse Vereniging van Heelkunde & Nederlandse Orthopaedische Vereniging; Richtlijn Proximale femurfracturen (2016) 68–81. https://www.cme-online.nl/sites/www.cme-online.nl/files/2016/08/richtlijn_proximale_femurfracturen.pdf
- 7.NICE (2011) The management of hip fracture in adults. https://www.nice.org.uk/guidance/cg124
- 8.ODEP Orthopaedic Data Evaluation Panel, U.K. http://www.odep.org.uk/product.aspx?pid=210
- 13.Parker MJ, Gurusamy KS, Azegami S (2010) Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev 16(6):CD001706Google Scholar
- 20.Branfoot T, Faraj AA, Porter P (2000) Cemented versus uncemented Thompson’s prosthesis: a randomised prospective functional outcome study. Injury 31:280–281Google Scholar
- 21.Harper WM, Greg PJ (1992) The treatment of intracapsular proximal femoral fractures: a randomized prospective trial. J Bone Joint Surg 74(Suppl iii):282Google Scholar
- 24.Moroni A, Pegreffi F et al (2009) Result in osteoporotic femoral neck fractures treated with cemented versus uncemented hip arthroplasty. J Bone Joint Surg Br 91-B(SUPP I):167Google Scholar
- 25.Cumming D, Parker M (2012) Randomised trial of cemented versus uncemented hemiarthroplasty for displaced intracapsular fractures. J Bone Joint Surg Br 94-B(SUPP III):63Google Scholar
- 29.Goltzman D (2002) Discoveries, drugs and skeletal disorders. Nat Rev Drug Discov 1:784–796Google Scholar
- 32.Pitto RP, Koessler M, Kuehle JW (1999) Comparison of fixation of the femoral component without cement and fixation with use of a bone-vacuum cementing technique for the prevention of fat embolism during total hip arthroplasty. A prospective, randomized clinical trial. J Bone Joint Surg Am 81(6):831–843CrossRefPubMedGoogle Scholar