title: Intraoperative blood pressure changes during cemented versus uncemented bipolar hemiarthroplasty for displaced femoral neck fracture: a multi-center cohort study : The effect of bone cement for bipolar hemiarthroplasty in elderly patients.
abstract: BACKGROUND
  The purpose of this study was to compare the cemented bipolar hemiarthroplasty with uncemented about the change of intraoperative blood pressure and the incidence of major complications in elderly patients with femoral neck fracture.
  
  
  METHODS
  This multiple center prospective cohort study included only patients with acute displaced femoral neck fracture (Garden stage III or IV). All patients were treated with cemented or uncemented bipolar hemiarthroplasty using modified Hardinge or Watson-Jones approach in the lateral decubitus position. Baseline data, medical history, type of anesthesia, FiO2value, the number of vasopressor using during operation, femoral component, intraoperative blood pressure, SaO2, and major complications were evaluated.
  
  
  RESULTS
  Of 164 patients (45 males and 119 females), 86 underwent cemented and 78 underwent uncemented bipolar hemiarthroplasty. Baseline medical histories were similar in both groups. In both the cemented and uncemented groups, intraoperative systolic blood pressure significantly decreased during cementing or rasping (106.3 and 103.6 mmHg) and after femoral component insertion (103.3 and 99.1 mmHg) compared to before rasping (120.7 and 116.4 mmHg) (p < 0.0001, respectively). Donaldson's grade seemed more favorable in uncemented group than in cemented group during cementing or rasping, during stem insertion; however, no patients experienced the lethal complication in both groups.
  
  
  CONCLUSIONS
  Intraoperative blood pressure did not change during cemented and uncemented bipolar hemiarthrplasty for displaced femoral neck fracture. If the standard modern cement technique was performed during operation, bone cement is a safe and acceptable for elderly patients who have a lot of medical histories.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan. shuichi0220miyamoto@helen.ocn.ne.jp.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Miyamoto
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Nakamura
authors.affiliation: Matudo City Hospital, 4005 Kamihongou, Matudo City, Chiba, 271-8511, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iida
authors.affiliation: Sanmu Medical Center, 167 Narutou, Sanmu City, Chiba, 289-1326, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Shigemura
authors.affiliation: Seirei Sakura Citizen Hospital, 2-36-2 Eharadai, Sakura City, Chiba, 285-8765, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Kishida
authors.affiliation: National Hospital Organization Chiba Medical Center, 4-1-2 Tubakinomori, Chuo-ku, Chiba City, Chiba, 260-8606, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Abe
authors.affiliation: Kimitu Central Hospital, 1010 Sakurai, Kisarazu City, Chiba, 292-8535, Japan.
authors.forename: Munenori
authors.initials: M
authors.lastname: Takeshita
authors.affiliation: Saiseikai Narashino Hospital, 1-1-1 Izumichou, Narashino City, Chiba, 275-8580, Japan.
authors.forename: Yoshitada
authors.initials: Y
authors.lastname: Harada
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan.
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260-8677, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D062785:Hemiarthroplasty / Q000379:methods*; D006801:Humans; D007022:Hypotension / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D001843:Bone Cements
keywords: Bipolar hemiarthroplasty; Cemented; Complication; Femoral neck fracture; Intraoperative blood pressure; Uncemented