title: More re-operations after uncemented than cemented hemiarthroplasty used in the treatment of displaced fractures of the femoral neck: an observational study of 11,116 hemiarthroplasties from a national register.
abstract: Using data from the Norwegian Hip Fracture Register, 8639 cemented and 2477 uncemented primary hemiarthroplasties for displaced fractures of the femoral neck in patients aged > 70 years were included in a prospective observational study. A total of 218 re-operations were performed after cemented and 128 after uncemented procedures. Survival of the hemiarthroplasties was calculated using the Kaplan-Meier method and hazard rate ratios (HRR) for revision were calculated using Cox regression analyses. At five years the implant survival was 97% (95% confidence interval (CI) 97 to 97) for cemented and 91% (95% CI 87 to 94) for uncemented hemiarthroplasties. Uncemented hemiarthroplasties had a 2.1 times increased risk of revision compared with cemented prostheses (95% confidence interval 1.7 to 2.6, p < 0.001). The increased risk was mainly caused by revisions for peri-prosthetic fracture (HRR = 17), aseptic loosening (HRR = 17), haematoma formation (HRR = 5.3), superficial infection (HRR = 4.6) and dislocation (HRR = 1.8). More intra-operative complications, including intra-operative death, were reported for the cemented hemiarthroplasties. However, in a time-dependent analysis, the HRR for re-operation in both groups increased as follow-up increased. This study showed that the risk for revision was higher for uncemented than for cemented hemiarthroplasties.
authors: Haukeland University Hospital, Department of Orthopaedic Surgery, N-5021 Bergen, Norway.
authors: J-E
authors: JE
authors: Gjertsen
authors: S A
authors: SA
authors: Lie
authors: T
authors: T
authors: Vinje
authors: L B
authors: LB
authors: Engesæter
authors: G
authors: G
authors: Hallan
authors: K
authors: K
authors: Matre
authors: O
authors: O
authors: Furnes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D002484:Cementation; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D009664:Norway / Q000453:epidemiology; D011446:Prospective Studies; D011475:Prosthesis Failure; D012042:Registries; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome