Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link?

Hong, Choon Chiet; Nashi, Nazrul; Makandura, Milindu Chanaka; Krishna, Lingaraj

doi:10.11622/smedj.2016030

Cited by 9 publications

(7 citation statements)

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“…Second, another difficulty is achieving initial stability. Although the use of a cemented stem has been proposed to solve this problem 20 21 22) , this is limitedly used because of a high mortality risk caused by fat embolism, cement embolism, vasodilation due to autonomic reflex and others in elderly patients with cardiovascular diseases 23) . We ensured solid fixation by using a cementless, double tapered, rectangular wedge-shaped, straight stem (Bencox®), and obtained excellent clinical and radiographic results at 2-year follow up 24 25) .…”

Section: Discussionmentioning

confidence: 99%

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

et al. 2017

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PurposeFemoral intertrochanteric fractures are common in the elderly. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation, and can aid in the recovery of biomechanical function of the hip. We evaluated clinical outcomes of bipolar hemiarthroplasty using a wiring technique for trochanteric fracture fragment fixation.Materials and MethodsFrom September 2006 to February 2015, a total of 260 cases underwent simultaneous bipolar hemiarthroplasty and wire fixation. A total of 65 patients (69 hips) with an average age of 78 years and more than one year of follow-up was included in the study. Using pre-, postoperative and follow-up radiograms, we evaluated wire fixation failure and also assessed changes in walking ability.ResultsLoosening or osteolysis around the stem was not observed; however, we did observe bone growth around the stem (54 cases), cortical hypertrophy (6 cases), a wide range of sclerotic lines but no stem subsidence (1 case), wire breakage (9 cases), and fracture fragment migration with no significant functional deficiency (2 cases).ConclusionOur study showed that additional wiring for trochanteric fracture fragment fixation following bipolar hemiarthroplasty can help restore normal anatomy. The added stability results in faster rehabilitation, and good clinical and radiographic outcomes. We recommend this procedure in this type of fracture.

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Section: Discussionmentioning

confidence: 99%

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

et al. 2017

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“…Of the 34 studies included in our analysis, 12 were randomized clinical trials [ 17 , 20 , 22 , 25 , 42 , 55 , 59 , 60 , 65 , 68 , 69 , 73 ] and 22 were observational studies [ 2 , 7 , 9 , 10 , 24 , 27 , 29 , 30 , 35 , 37 , 40 , 44 , 47 , 51 , 52 , 57 , 61 , 70 , 72 , 75 – 77 ]. The 34 included studies investigated a total of 42,411 participants; among whom 32,385 underwent cemented hemiarthroplasty and 10,026 underwent uncemented hemiarthroplasty (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…of patients (%) Mean age, years No. female (%) Study period Mean follow-up CH UCH CH UCH CH UCH Prashanth et al 2017 [ 57 ] Observational study 24 (46) 28 (54) 70 30 (58) 2006–2014 59 months Choi et al 2016 [ 9 ] Observational study 115 (64) 65 (36) 77 76 84 (73) 46 (71) 2009–2014 27 months Khorami et al 2016 [ 40 ] Observational study 22 (43) 29 (57) 79 71.1 20 (90) 12 (41) 2011–2013 19.2 months Hong et al 2016 [ 35 ] Observational study 133 (49.1) 138 (50.9) 76 75.2 104 (78.2) 100 (72.5) 2011–2013 12 months Cicek et al 2015 [ 10 ] Observational study 43 (51.2) 41 (48.8) 75.65 77.52 23 (53.5) 23 (56.1) 2007–2012 46.1 months Grammatopoulos et al 2015 [ 30 ] Observational study 292 (71) 120 (29) 82.1 83.4 196 (67.1) 79 (65.8) 2010–2012 12 months Morris et al 2015 [ 51 ] Observational study 33 (41.25) 47 (58.75) 83.3 83.1 12 (36.4) 16 (34) 2013–2014...…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, higher levels of cytokine CD14/42a, a known measure of platelet–monocyte aggregation, are present in patients undergoing cemented arthroplasty [ 8 ]. In contrast, a small study by Hong et al reported no statistically significant difference in DVT development between cemented and uncemented hemiarthroplasty prostheses used to treat traumatic displaced femoral neck fractures (3.0% [ n = 4] and 5.1% [ n = 7], respectively) [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Type of Femoral Component Fixation on Mortality and Morbidity after Hip Hemiarthroplasty: A Systematic Review and Meta-Analysis

Imam

Shehata

Morsi

et al. 2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background Hip hemiarthroplasty is a well-established treatment of displaced femoral neck fracture, although debate exists over whether cemented or uncemented fixation is superior. Uncemented prostheses have typically been used in younger, healthier patients and cemented prostheses in older patients with less-stable bone. Also, earlier research has suggested that bone cement has cytotoxic effects and may trigger cardiovascular and respiratory adverse events. Questions/Purposes The aim of this systematic review and meta-analysis was to compare morbidity and mortality rates after cemented and uncemented hemiarthroplasty for the treatment of displaced femoral neck fractures in elderly patients. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched seven medical databases for randomized clinical trials and observational studies. We compared cemented and uncemented hemiarthroplasty using the Harris Hip Score (HHS), as well as measures of postoperative pain, mortality, and complications. Data were extracted and pooled as risk ratios or standardized mean difference with their corresponding 95% confidence intervals in a meta-analysis model. Results The meta-analysis included 34 studies (12 randomized trials and 22 observational studies), with a total of 42,411 patients. In the pooled estimate, cemented hemiarthroplasty was associated with less risk of postoperative pain than uncemented hemiarthroplasty. There were no significant differences between groups regarding HHS or rates of postoperative mortality, pulmonary embolism, cardiac arrest, myocardial infarction, acute cardiac arrhythmia, or deep venous thrombosis. Conclusions While we found that cemented hemiarthroplasty results in less postoperative pain than uncemented hemiarthroplasty in older patients with femoral neck fracture, the lack of significant differences in functional hip scores, mortality, and complications was surprising. Further high-level research is needed.

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“…In THA, the femoral stem should be selected according to patient's diagnosis, BMD and shape of the femur. The use of a cemented stem allows early ambulation by obtaining initial firm fixation 12 13 14) . However, cardiovascular complications have been associated with this approach (e.g., intraoperative fat embolism, bone cement embolism, vasodilation due to autonomic reflex); additionally, failure of biologic fixation, thigh pain, stress-shielding, bone resorption and loosening, and difficulty of stem extraction in revision surgery have been reported at both mid- and long-term follow-up 15 16) .…”

Section: Discussionmentioning

confidence: 99%

Hip Arthroplasty Using the Bencox^® Hip System: An Evaluation of a Consecutive Series of One Thousand Cases

2018

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PurposeThis is a report on the outcomes associated with a consecutive series of 1,000 cementless hip arthroplasties utilizing the Bencox® hip stem–the first Korean-developed hip prosthesis.Materials and MethodsA consecutive series of 1,000 hip arthroplasties using the Bencox® hip stem were analyzed, starting from its initial release (September 2006) until June 2014. Patients in this consecutive series underwent surgery for fractures (n=552), arthritis (n=155), avascular necrosis (n=209), and revisions (n=84). Of these 1,000 cases, patients with a minimum follow-up of at least 1 year (n=616) were retrospectively analyzed for radiographic and clinical outcomes (i.e., Harris hip score). The stability of the prosthesis was evaluated by examining subsidence.ResultsDuring the follow-up period (mean follow-up period of 54.8 months), there were 2 cases requiring revision of the femoral stem–both were caused by periprosthetic fractures and neither involved stem loosening. The mean Harris hip score during follow-up was 95.5. Bone ongrowth occurred in 95% of patients; no cases of subsidence or aseptic loosening of the stem were detected, and no cases of postoperative complications such as ceramic breakage were observed.ConclusionClinical and radiographic evaluations of hip arthroplasty using the Bencox® hip stem revealed excellent outcomes with an average of 54.8 month follow-up in a consecutive series of 1,000 cases.

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Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link?

Cited by 9 publications

References 20 publications

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

The Effect of Type of Femoral Component Fixation on Mortality and Morbidity after Hip Hemiarthroplasty: A Systematic Review and Meta-Analysis

Hip Arthroplasty Using the Bencox^® Hip System: An Evaluation of a Consecutive Series of One Thousand Cases

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Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link?

Cited by 9 publications

References 20 publications

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

Wiring Techniques for the Fixation of Trochanteric Fragments during Bipolar Hemiarthroplasty for Femoral Intertrochanteric Fracture: Clinical Study and Technical Note

The Effect of Type of Femoral Component Fixation on Mortality and Morbidity after Hip Hemiarthroplasty: A Systematic Review and Meta-Analysis

Hip Arthroplasty Using the Bencox® Hip System: An Evaluation of a Consecutive Series of One Thousand Cases

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Hip Arthroplasty Using the Bencox^® Hip System: An Evaluation of a Consecutive Series of One Thousand Cases