title: Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link?
abstract: BACKGROUND
  Traumatic displaced femoral neck fractures in the elderly can be treated with cemented or uncemented hemiarthroplasty with good outcomes. Earlier studies reported a higher incidence of deep vein thrombosis (DVT) associated with cemented prostheses in elective total hip or knee arthroplasty. In addition, the hypercoagulable state after a traumatic femoral neck fracture and possible thrombogenic properties of bone cement could put these patients at greater risk for thromboembolism. We aimed to compare the incidence of DVT and progression to pulmonary embolism (PE) or mortality in cemented and uncemented hemiarthroplasty.
  
  
  METHODS
  The data of 271 patients treated with cemented or uncemented hemiarthroplasty after a traumatic displaced femoral neck fracture was retrospectively analysed for the incidence of DVT. The level of thrombosis, progression to PE and mortality were compared.
  
  
  RESULTS
  There were 133 (49.1%) patients with cemented hemiarthroplasty, while 138 (50.9%) had uncemented hemiarthroplasty. The patients had an average age of 76.6 (range 53-99) years and 11 (4.1%) patients had DVT. There were no significant differences in development of DVT, level of thrombosis, PE and mortality regardless of whether a cemented or an uncemented prosthesis was used.
  
  
  CONCLUSIONS
  Cemented hemiarthroplasty is not associated with higher risks of DVT, PE or mortality in patients with traumatic displaced femoral neck fracture. Cemented prostheses can be safely used for this group of patients.
authors.affiliation: Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Choon Chiet
authors.initials: CC
authors.lastname: Hong
authors.affiliation: Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Nazrul
authors.initials: N
authors.lastname: Nashi
authors.affiliation: Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Milindu Chanaka
authors.initials: MC
authors.lastname: Makandura
authors.affiliation: Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
authors.forename: Lingaraj
authors.initials: L
authors.lastname: Krishna
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000601:surgery*; D062785:Hemiarthroplasty / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012308:Risk Management; D012846:Singapore / Q000453:epidemiology; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*
chemical_list: D001843:Bone Cements
keywords: bone cement; cemented hemiarthroplasty; deep vein thrombosis; displaced femoral neck fracture; hypercoagulable