Cemented versus uncemented femoral component total hip arthroplasty in elderly patients with primary osteoporosis: retrospective analysis with 5-year follow-up

Abstract

Objective To compare medium-term clinical and radiological outcomes of primary unilateral uncemented (UN) or cemented (CE) femoral component total hip arthroplasty (THA) in elderly patients with osteoporosis. Methods Consecutive patients with osteoporosis who underwent primary unilateral UN or CE THAs at our institution from 2006 to 2013 were retrospectively reviewed. All consecutive procedures were managed by high-volume surgeons, using UN or CE THA approaches. Follow-up assessments occurred at 1, 3, 6, 9, and 12 months postoperatively, and yearly thereafter. Patient-related functional outcomes were assessed using the Harris Hip Score (HHS). Primary and secondary endpoints were early revision (<5 years) and functional outcome. Results In total, 496 primary unilateral THAs (CE, n = 184; UN, n = 182) were assessed with a median follow-up period of 75 months (range, 65–86 months). From 3 months after surgery to the final follow-up, HHS was consistently superior in the CE group. Respective prosthetic loosening rates in the UN and CE groups were 26.4% and 16.8% at a minimum of 5 years. There was a significant difference in rate of early revision (7.6% CE vs. 14.8% UN). Conclusion Compared with UN THA, CE THA exhibits a superior outcome in elderly patients with primary osteoporosis.

Uncemented versus cemented total hip arthroplasty for displaced femoral neck fractures in elderly patients with osteoporosis: A retrospective analysis

“…8,10 The notable dissimilarities in the results of these various studies on hip-related complications may be largely attributed to the design of the prosthesis (prosthesis size and material selection) and the surgeon's experience. 4,6 This study has several limitations. It had a small sample, and its retrospective design is association with some inherent disadvantages.…”

“…The current findings are consistent with previous studies. 3,6,14,15 Although the better functional outcomes and lower rates of revision, loosening, periprosthetic fracture, and dislocation are apt to favour CTA, no significant between-group differences in the HHS were detected during the initial 2 years after surgery. Probable explanations include the time-dependent clinical efficacy of the implants and the properties of the prostheses.…”

“…9 The lack of consensus regarding which technique (UTA or CTA) is preferable for treating FNFs (AO/OTA: 31B/C) in elderly individuals is related to the remarkable distinction in clinical outcomes between the two types of implants. 6,10 Most previous studies have involved highly concentrated medical centres and several brands of prostheses. 3,5,6 Additionally, short-term follow-up is commonplace in these studies.…”

“… 4 However, recent studies of UTA in elderly individuals have demonstrated encouraging short-term clinical outcomes. 6 , 7 Moreover, cemented prosthesis syndrome tends to occur more frequently in CTA than UTA. 8 Cemented prosthesis syndrome theoretically poses a significant threat to the patient’s life, although the specific probability of this threat has not been calculated.…”

Assessment of Functional Outcome between Cemented and Uncemented Total Hip Replacement: A Comparative Study

“…This difference was also found to be statistically significant and the results of the present study was found to be in concordance with the studies done by Chen Yang et al and Corten K et al where rate of revision and HHS among patients who underwent cemented THA were better than those of patients who underwent uncemented THA. 14,15 The limitations were more follow-up time period for both the groups with the larger sample size.…”