Cemented or cementless THA in patients over 80 years with fracture neck of femur: a prospective comparative trial

Gavaskar, Ashok S.; Tummala, Naveen C.; Subramanian, Muthukumar

doi:10.1007/s12306-013-0296-6

Cited by 20 publications

(22 citation statements)

References 14 publications

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“…Other authors have documented the low rate of acetabular erosion with bipolar hemiarthroplasty. 8,9,17,21 The 6-month mortality rate in our series was 6% and 2-year mortality was 10.9% which was toward the lower end of spectrum of the rate reported by other studies (11%-27%). [22][23][24][25] The low mortality in our series could be attributed to the relatively younger cohort with less comorbidities, early surgery with mobilization, VTE prophylaxis, and comprehensive geriatric care.…”

Section: Discussionsupporting

confidence: 43%

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Jain

Selhi

Mears

et al. 2015

Geriatr Orthop Surg Rehabil

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Geriatric hip fractures are a challenging clinical problem throughout the world. Hip fracture services have been shown to shorten time to surgery, decrease the cost of admissions, and improve the outcomes. We instituted a geriatric hip fracture program for comanagement of these injuries by orthopedic and internal medicine teams at our hospital in India. From January 2010 till December 2011, 119 patients with a femoral neck fracture were treated with cemented modular hemiarthroplasty under this program using a cost-effective Indian implant. The cohort included 63 males and 56 females with a mean age of 70.7 years (range 55-98 years). Hypertension (n ¼ 42) and diabetes mellitus (n ¼ 29) were the most common comorbidities. The follow-up period ranged from 12 to 37 months with an average of 24 months. The surgery was performed within 24 hours of admission in 60.5% (n ¼ 72) patients. The use of antiplatelet drugs was the most common reason for delay of surgery. The mean length of hospital stay was 10.4 days (range 3-24 days) with 77% (n ¼ 92) of patients discharged within 1 week of admission. On follow-up, good to excellent Harris hip scores were seen in 88% of patients with 76% of patients returning to the preinjury ambulatory status. The mortality rate was 6% at 6 months follow-up and 10.9% at 2 years. Our study shows that a hip fracture program can be instituted in India. The program helped us in achieving the goal of early surgery, mobilization, and discharge from hospital with decreased mortality.

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Section: Discussionsupporting

confidence: 43%

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Jain

Selhi

Mears

et al. 2015

Geriatr Orthop Surg Rehabil

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“…The results of the current study are in agreement with reports on the use of cementless hemiarthroplasty overall and for cementless fixation of stems for elective THA. 12,17,[20][21][22] Bezwada et al 17 compared the clinical outcomes of 248 patients (256 hips) with a mean age of 77 years (range, 65-95 years) who sustained displaced femoral neck fractures treated with cementless bipolar hemiarthroplasties. At a mean follow-up of 3.5 years (range, 3-5 years), the revision rate was 5% and the mean Harris Hip score improved to 82 points (range, 54-92 points).…”

Section: Discussionmentioning

confidence: 99%

Proximally Coated Cementless Bipolar Hemiarthroplasty in Dorr Type C Bone

Bonutti¹,

Stroh²,

Issa³

et al. 2014

Orthopedics

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The current study was conducted to examine the clinical and radiographic outcomes of cementless bipolar arthroplasty in patients who had type C bone at the time of the procedure. A total of 87 patients (105 hips) who had type C femora and had undergone cementless bipolar hemiarthroplasty with a proximally coated cementless prosthesis for the treatment of displaced femoral neck fractures at a single institution were reviewed. Patients included 83 women and 4 men who had a mean age of 84 years (range, 72-100 years) and were followed for a mean of 6 years (range, 2-11 years). Outcomes evaluated included aseptic implant survivorship, surgical complications, Harris Hip scores, and radiographic findings. At final follow-up, there were no revisions for aseptic implant loosening. The overall aseptic implant survivorship was 95%, with 5 patients undergoing revision surgery for aseptic reasons. Three revisions were because of periprosthetic fractures after falls, 1 revision was because of intractable groin pain, and 1 revision was because of recurrent dislocations. The surgical complication rate was 8.5%, which included 3 septic revisions, 2 avulsion fractures of the greater trochanter after falls, 2 superficial wound infections, 1 recurrent dislocation, and 1 wound hematoma. The mean Harris Hip score had improved to 80 points (range, 30-97 points) at final follow-up. Despite generally poor bone quality and medical comorbidities, elderly patients with displaced femoral neck fractures achieved excellent clinical outcomes, with few perioperative complications, through the use of proximally coated cementless bipolar hemiarthroplasty.

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“…After duplication and reading full-text, sixteen studies were enrolled in this review. Among the sixteen studies, twelve of them were RCT [13,14,[18][19][20][21][22][23][24][25][26][27] and four of them were prospective cohort studies [3,[28][29][30]. There were 2180 hips analyzed in the 16 studies:…”

Section: Characteristics and Qualities Of The Studies Includedmentioning

confidence: 99%

“…Of the sixteen studies, eight studies used observed blinding [13,14,18,19,22,23,26,27], ten studies reported complete outcome [13, 14, 18-23, 25, 27], and ten studies reported all outcome date without reporting bias [13, 14, 18-23, 25, 27]. For prospective cohorts, three studies received eight score points [3,28,30] and one study received seven score points [29]. The detailed were shown in Fig.…”

Section: Characteristics and Qualities Of The Studies Includedmentioning

confidence: 99%

“…The operation time in the uncemented group was significantly shorter than that in the cemented group [mean difference (MD) 11.70, 95% CI 0.42-22.98, P = 0.04]. On sensitivity analysis, one study [30] was found to be a major contributor to heterogeneity (Fig S1B). After exclusion of this study, operation time in the uncemented group was still significantly lower but with lesser heterogeneity among the included studies (MD 8.01, 95% CI 6.18-9.85, P < 0.00001, I 2 = 39%).…”

Section: Operation Timementioning

confidence: 99%

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Cemented versus uncemented arthroplasty for the management of femoral neck fractures in the elderly

Yang

Jiang

et al. 2020

Preprint

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Background Hemiarthroplasty and total hip arthroplasty (TKA) are commonly used to treat unstable femoral neck fractures in older patients. However, there is no consensus on the use of cement during hemiarthroplasty and TKA. Previous reviews on this subject included small number of studies and lacked evidence grading of outcomes. In this study, we aimed to compare the outcomes of cemented and uncemented arthroplasty for the treatment of femoral neck fractures in older patients. Methods A meta-analysis was conducted according to the guidelines of the Cochrane Collaboration using online databases (Pubmed, Cochrane Central Register of Controlled Trials, and Ovid). The quality of the included studies was assessed using the Cochrane Collaboration tool and Newcastle-Ottawa Scale. Prospective cohort studies and randomized controlled trials (RCT) of cemented arthroplasty versus uncemented arthroplasty for treatment of femoral neck fractures were analyzed using Review Manager (version 5.2) software. Results Sixteen studies were included in the meta-analysis. Cemented arthroplasty was found to be superior to uncemented arthroplasty with respect to reoperation rate, complications related to prosthesis, residual pain, and operation time. There were no significant between-group differences with respect to local and general complications, duration of hospital stay, hip function, and mortality. Conclusion Compared with cemented arthroplasty, uncemented arthroplasty was associated with a greater risk of complications related to prosthesis, reoperation rate, residual pain, and longer operation time. However, the results of this meta-analysis should be interpreted cautiously owing to some limitations. Further studies are required to provide more robust evidence.

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Cemented or cementless THA in patients over 80 years with fracture neck of femur: a prospective comparative trial

Cited by 20 publications

References 14 publications

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Early Results of a Geriatric Hip Fracture Program in India for Femoral Neck Fracture

Proximally Coated Cementless Bipolar Hemiarthroplasty in Dorr Type C Bone

Cemented versus uncemented arthroplasty for the management of femoral neck fractures in the elderly

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