Long-term survival after cemented versus uncemented total hip arthroplasty for treatment of acute femoral neck fracture: a retrospective study with a mean 10-year follow-up

Abstract

Objective To compare the long-term survivorship and Harris hip scores (HHSs) between cemented total hip arthroplasty (CTHA) and uncemented total hip arthroplasty (UTHA) for treatment of acute femoral neck fractures (FNFs). Methods Data of 224 hips (CTHA, n = 112; UTHA, n = 112) that underwent primary surgery in our medical institution from 2005 to 2017 were retrospectively analysed. The primary endpoint was the risk of all-cause revision. The difference in the risk of all-cause revision between the two groups was assessed by Kaplan–Meier survival analysis with a log-rank test and Cox regression analysis. Results The mean postoperative follow-up was 10 years (range, 3–13 years). The Kaplan–Meier estimated 10-year implant survival rate was significantly higher in the CTHA than UTHA group (98.1% vs. 96.2%, respectively). The adjusted Cox regression analysis demonstrated a significantly lower risk of revision in the CTHA than UTHA group. At the final follow-up, the mean HHS was significantly higher in the CTHA than UTHA group (85.10 vs. 79.11, respectively). Conclusion This retrospective analysis demonstrated that CTHA provided higher survival, lower revision risk, and higher functional outcome scores than UTHA. Further follow-up is necessary to verify whether these advantages of CTHA persist over time.

Incidence and treatment of intracapsular femoral neck fractures in Germany

“…Parker et al [29] reported a clear advantage of cemented arthroplasties with regard to faster mobilization and reduction of postoperative pain in a systematic review [29]. Furthermore, the rate of aseptic revisions was significantly reduced among cemented hemiarthroplasties and total hip arthroplasties [27,[30][31][32]. For cemented hemiarthroplasties within the first 2 days after surgery, Fenelon et al [33] reported an increased mortality compared to uncemented stems.…”

Comparison of functional outcomes and complications of cemented vs uncemented total hip arthroplasty in the elderly neck of femur fracture patients: A systematic review and meta-analysis

“…The revision rates of the uncemented prosthesis were significantly higher (66/444 vs 27/ 441) which was seen consistently in all studies reporting revision rates. 1,11,14,15 This analysis suggests that cemented fixation gives favorable results in elderly patients with neck or femur fractures, as demonstrated by all studies included in the analysis. In contrast, some previous studies did not find a difference in the overall mortality rates, complications, and functional and radiological results, which were similar in patients undergoing an uncemented with those undergoing a cemented THA performed for hip fracture.…”

“…Four studies compared HHS between groups of more than 5 years. 1,11,13,15 The HHS score was seen to be more in the cemented group in comparison with the uncemented group and was statistically significant (MD ¼ 5.20; CI ¼ À6.68 to À3.73; P < 0.00001) (Figure -2).…”

“…Four included studies reported revision rate. 1,11,14,15 The uncemented THRs had a higher statistically significant revision rate (OR ¼ 2.60; 95% CI ¼ 1.61 to 4.20; P < 0.00001) with nonsignificant homogeneity (I 2 ¼ 0%) for this outcome (Fig. 4).…”

Long-term survival of hybrid total hip replacement for prior failed proximal femoral nail antirotation: a retrospective study with a median 10-year follow-up

“…To date, few studies on converting failed PFNAs provide effective consensus recommendations for reducing or avoiding mechanical failures [ 30 , 31 ]. Lack of the design and material characteristics of THR implants can lead to remarkable distinctions in comparisons between studies [ 32 , 33 ]. The long-term outcomes of hybrid THR for elderly individuals remain controversial [ 21 , 27 ].…”