Is there a difference in perioperative mortality between cemented and uncemented implants in hip fracture surgery?

Hossain, Munier; Andrew, JG

doi:10.1016/j.injury.2012.08.043

Cited by 45 publications

(67 citation statements)

References 20 publications

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“…[13][14][15][16] As cemented hemiarthroplasty is more commonly used, the effect of cementation on mortality, caused by elevating the intramedullary pressure which leads to fat embolization, has become one of the main concerns of physicians. [6][7][8]17,18] Contradictory results were obtained in these studies. Elmaraghy et al [6] suggested that cemented hemiarthroplasty had no effect on the formation of fat emboli, but Christie et al [7] showed that cemented arthroplasty caused greater and more prolonged embolic cascades than did uncemented arthroplasty.…”

Section: Discussionmentioning

confidence: 62%

“…A review article on 7,774 patients with hip fractures concluded that cemented arthroplasty caused significantly higher mortality. [17] Hossain et al [18] reported eight cases of perioperative death after cemented hemiarthroplasty in elderly patients. Our results supported these studies, which suggested serious adverse effects of cement on mortality.…”

Section: Discussionmentioning

confidence: 99%

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Cemented calcar replacement versus cementless hemiarthroplasty for unstable intertrochanteric femur fractures in elderly.

Çankaya¹,

Özkurt²,

Tabak³

2013

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Unstable intertrochanteric fractures remain a challenging problem in elderly individuals due to high failure rates associated with internal fixation. Hemiarthroplasty is one treatment option for intertrochanteric femur fractures in elderly patients. The aim of the present study was to compare the reliability of cementless and cemented hemiarthroplasty for unstable intertrochanteric femur fractures in elderly patients.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Cemented calcar replacement versus cementless hemiarthroplasty for unstable intertrochanteric femur fractures in elderly.

Çankaya¹,

Özkurt²,

Tabak³

2013

Ulus Travma Acil Cerrahi Derg

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“…The reported risk of cement-related death is low but not negligible [8,11,13,20,21]. Whereas some uncemented hemiarthroplasties have shown equivalent clinical results as cemented counterparts, an increased risk of subsequent fractures is evident.…”

Section: Discussionmentioning

confidence: 99%

“…Thirty-six surgeons performed a median of five operations each (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Patients underwent a bipolar hemiarthroplasty with either a cemented femoral stem (Spectron; Smith & Nephew, Memphis, TN, USA) (Fig.…”

Section: Methodsmentioning

confidence: 99%

Cemented versus Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures: 5-year Followup of a Randomized Trial

Langslet

Frihagen

Opland

et al. 2014

Clinical Orthopaedics &Amp; Related Research

193

162

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Background Displaced femoral neck fractures usually are treated with hemiarthroplasty. However, the degree to which the design of the implant used (cemented or uncemented) affects the outcome is not known and may be therapeutically important. Questions/purposes In this randomized controlled trial, we sought to compare cemented with cementless fixation in bipolar hemiarthroplasties at 5 years in terms of (1) Harris hip scores; (2) femoral fractures; (3) overall health outcomes using the Barthel Index and EQ-5D scores; and (4) complications, reoperations, and mortality since our earlier report on this cohort at 1-year followup. Methods We present followup at a median of 5 years after surgery (range, 56-65 months) from a randomized trial comparing a cemented hemiarthroplasty (112 hips) with an uncemented, hydroxyapatite-coated hemiarthroplasty (108 hips), both with a bipolar head. Results were previously reported at 1-year followup. Harris hip scores, Barthel Index, and EQ-5D scores were assessed by one research nurse and one orthopaedic surgeon. Complications and reoperations were determined by chart review and radiographs examined by three orthopaedic surgeons. Sixty patients (56%) had died in the cemented group and 63 (60%) in the uncemented group. Respectively, three and two patients (2.7% and 1.9%) were completely lost to followup. Results Harris hip scores at 5 years were higher in the uncemented group than in the cemented group (86.2 versus 76.3; mean difference 9.9; 95% confidence interval [CI], 1.9-17.9). The prevalence of postoperative periprosthetic femoral fractures was 7.4% in the uncemented group and 0.9% in the cemented group (hazard ratio [HR], 9.3; 95% CI, 1.16-74.5). Barthel Index and EQ-5D scores were not different between the groups. Between 1 and 5 years, we found no additional infections or dislocations. The mortality rate was not different between the groups (HR, 1.2; 95% CI, 0.82-1.7).

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“…The bone cementation increase the intramedullary pressure which may lead to fat embolization. This effect on mortality has become a major concern [18][19][20][21][22] . Christie et al reported that cementation leads to significant fat embolisim cascades than the uncemented hemiarthroplasty [19] .…”

Section: Discussionmentioning

confidence: 99%

A comparative study of treatment of unstable intertrochanteric fractures with PFN and cemented hemiarthroplasty

Rajarajan¹

2018

Int. J. Orthop. Sci.

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Aim: Aim of the study is to analyse and compare the functional outcomes and radiological results of two different surgical modalities, PFN and cemented hemiarthroplasty in the treatment of unstable intertrochanteric fractures in elderly patients. Background: Elderly patients with intertrochanteric fractures should be mobilized early to reduce the morbidity and mortality. While cemented hemiarthroplasty allows early weight bearing, the prolonged surgical time increase the blood loss and mortality, whereas with PFN once the fracture becomes stable allows early mobilization thus overcoming the problems of recumbency. PFN efficiently preserves the femoral head and the abductor mechanism and thus has the biomechanical advantage of increased range of hip joint movements and better functional outcome. Materials and methods: Sixty patients of age 60 years and above with comminuted intertrochanteric fractures treated by PFN or cemented hemiarthroplasty were taken up for the prospective study in our institute between january2013 and june 2015. 30 patients underwent PFN and 30 patients had hemiarthroplasty. Average period of follow up was 2 years. Post-operative complications and mortality rates were compared between the two groups. Functional results and the hip range of movements were assessed by Harris Hip Score (HHS). In the mean follow up period of 22months radiological examination was done to assess the results & complications. Results:The demographic and background data of the patients in the two groups are statistically similar. At 2 years follow up PFN group patients had a mean HHS of 85.89 and HA group had 78.11. Pain, severity and range of hip movements are better in PFN group than HA group. Radiologicaly 4 patients in HA group had stem loosening and 2 patients had screw cut out in the PFN group with subsequent pain in the final follow up. Conclusion: PFN is a better option for the treatment of elderly intertrochanteric fractures as the operative time is short, easier surgical procedure & has less mortality. PFN also gives a better functional outcome in the late follow up than hemiarthoplasty.

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Is there a difference in perioperative mortality between cemented and uncemented implants in hip fracture surgery?

Cited by 45 publications

References 20 publications

Cemented calcar replacement versus cementless hemiarthroplasty for unstable intertrochanteric femur fractures in elderly.

Cemented calcar replacement versus cementless hemiarthroplasty for unstable intertrochanteric femur fractures in elderly.

Cemented versus Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures: 5-year Followup of a Randomized Trial

A comparative study of treatment of unstable intertrochanteric fractures with PFN and cemented hemiarthroplasty

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