Comparison of Postoperative Infection-Related Complications between Cemented and Cementless Hemiarthroplasty in Elderly Patients: A Meta-Analysis

Yoon, Byung‐Ho; Seo, Jeong Gook; Koo, Kyung Hoi

doi:10.4055/cios.2017.9.2.145

Cited by 10 publications

(7 citation statements)

References 30 publications

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“…Our study shows that pneumonia and urinary tract infection occurred less frequently in the CHA group, with no statistically signi cant difference. This is consistent with Yoon's [42] conclusion. This may be due to early ambulation or early urinary catheter removal in the CHA group [42].…”

Section: Common Complicationssupporting

confidence: 92%

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Comparison Between Cemented and Uncemented Hemiarthroplasty in Patients With Femoral Neck Fractures: A Systematic Review and Meta-analysis

Tang¹,

Liu²,

Chen³

et al. 2020

Preprint

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BackgroundWe performed an updated systematic review and meta-analysis to compare the outcomes of CHA and UCHA in patients with FNFs.MethodsWe searched 6 English databases (Cochrane Library, ScienceDirect, PubMed, Embase, Medline, and Web of Science) and 4 Chinese databases (CNKI, VIP, Wang Fang, and Sino Med) in July 2020. The quality of each study was assessed according to the Cochrane handbook of systematic reviews. Data were pooled as risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs). We used the random-effects model despite the heterogeneity among the studies. Data regarding baseline characteristics, hip function, complications both prosthetic-related and common, and operative outcomes are reported. ResultsA total of 24 RCTs based on 22 trials involving 3119 patients (CHA, 1575; UCHA, 1544) were included. Patients in CHA group show better hip function with HHS within 6 weeks (WMD=9.097, 95% CI, 3.034-15.161; P<0.003), 3 months (WMD=3.347, 95% CI, 1.478-5.216; P<0.001), 12 months (WMD=2.183, 95% CI, 0.161-4.205; P=0.034). The pooled results show that CHA had lower rates of refracture (RR=0.227, 95% CI, 0.135-0.381; P<0.0001), subsidence or loosening (RR=0.295, 95% CI, 0.112,0.778; P<0.014) and revision (RR=0.468, 95% CI, 0.279-0.786; P=0.004). Furthermore, CHA group tend to have lower pain(VAS score) (WMD=-0.568, 95% CI, -0.897 to -0.239; P=0.001), lower rate of pressure injury(RR=0.432, 95% CI, 0.221-0.846; P=0.014) and mortality at 1 year after surgery(RR=0.852, 95% CI, 0.727-0.998; P=0.047). UCHA showed a shorter operative duration(WMD=8.739, 95% CI, 6.354-11.124; P<0.0001).ConclusionsThis meta-analysis demonstrates that CHA has better hip function, lower rates of refracture, subsidence or loosening, revision, pressure ulcer, pain and one-year mortality than UCHA, while UCHA has shorter operative duration.

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Section: Common Complicationssupporting

confidence: 92%

“…This is consistent with Yoon's [42] conclusion. This may be due to early ambulation or early urinary catheter removal in the CHA group [42].…”

Section: Common Complicationssupporting

confidence: 92%

Comparison Between Cemented and Uncemented Hemiarthroplasty in Patients With Femoral Neck Fractures: A Systematic Review and Meta-analysis

Tang¹,

Liu²,

Chen³

et al. 2020

Preprint

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“…PCBH allows for early mobilization and sufficient fixation, reducing the risk of postoperative complications such as pneumonia, atelectasis, pressure sores, and pseudoarthrosis. 10,11 The Pakistani perspective regarding the utilization of PCBH as primary treatment modality is limited, therefore in current study we have analysed the early outcome of primary cemented bipolar hemi arthroplasty in cases of unstable osteoporotic intertrochanteric femur fractures in elder patients.…”

Section: Discussionmentioning

confidence: 99%

Is Cemented Bipolar Hemiarthroplasty Good Choice for Unstable Intertrochanteric Fractures in Elderly: Multicenteric Prospective Study at Karachi

Rajput

Memon

Azam³

et al. 2022

J Ayub Med Coll Abbottabad

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Background: To analyse the functional outcome of primary cemented bipolar hemi arthroplasty (PCBH) for unstable osteoporotic intertrochanteric femur fractures in elderly patients. Methods: It was a multicentre prospective study conducted at Institute of Orthopaedics & Surgery, Medicare Cardiac & General Hospital and Dr Ruth K M Pfau Civil Hospital Karachi, Pakistan from February 2015 to July 2020. Thirty-eight patients of 60–90 years of either gender diagnosed as close UIF, severe osteoporosis as per Singh index grade ≤3, time since injury <2 weeks, ASA status II & III and pre-injury independent walking were enrolled in this study. All patients with UIF underwent PCBH. The radiographs were performed before surgery and at intervals postoperatively. All patients were requested to come for follow up visits at 2 weeks, 4 weeks, 3 months, 6 months 1 year and then at 3 years to assess the functional outcome of patients. At first postoperative day check X-rays taken and rehabilitation started as per institutional rehabilitation protocol, at 2-week stiches removed, at 4 weeks’ x-ray was done and all the patients were followed for 3 years. The primary outcomes were noted using Harris Hip Score (HHS) for the functional outcome assessed at the end of 1 year and at final follow up. Results: The mean age of the study participants was 68.29±8.04 years. One male (2.6%) died at 6th month, then 2 females (5.2%) patients died at 1 year and 2 females (5.2%) patients died at the end of 3 years due to multiple comorbid conditions. During 1st year 3 patients (7.4%) developed DVT and 4 patients (10.5%) having diabetes and hypertension developed superficial wound infection. The mean Harris Hip Score between time points which indicated that the mean Harris Hip Score significantly improve over the period of time (p=0.001). Post hoc tests revealed that there were statistically significant differences between each time points (p<0.05). The functional outcome at 3 years, shown, one patient had excellent outcome, 24 patients had good outcome and 8 had fair outcome, respectively. Conclusion: The Primary Cemented Bipolar Hemiarthoplasty is a good choice of treatment in terms of reasonable functional outcome such as early mobilization and associated with less post-operative complications in elderly patients of UIF.

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“…1,2 In the early years, cemented stems were preferred over cementless stems. [3][4][5] However, inherent complications of cemented stems such as intraoperative embolism and subsequent cardiopulmonary complications have led to constant improvement of cementless stem designs. 6,7 A few surface treatment methods that strengthen biologic fixation have also been developed.…”

Section: Introductionmentioning

confidence: 99%

Minimum 10-year follow-up of micro-arc oxidation coating on a cementless grit-blasted tapered-wedge stem of total hip arthroplasty: a multicentre study

et al. 2020

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Background: Recently, a femoral stem treated with grit-blasting and micro-arc oxidation (MAO) coating has commercialised but medium-term follow-up studies are lacking. The aim of this study was to report the outcome of a grit-blasted and MAO-coated femoral component designed as a straight, double-wedged, tapered stem with a rectangular cross-section with minimum 10 years follow-up. Methods: Between March 2006 and December 2008, 309 primary total hip arthroplasties using a grit-blasted and MAO-coated femoral component were performed by 3 experienced hip surgeons in 3 hospitals. At minimum 10 years after index THA, 299 hips were living, 10 hips were deceased, and 65 hips were lost to follow-up or had a follow-up period <10 years. Finally, 234 hips were enrolled in this study. Results: Mean duration of clinical follow-up was 129.6 months. The mean Harris Hip Score was improved from 46.9 to 88.4 at the final follow-up. 4 hips were revised for 2 aseptic femoral loosening, 1 aseptic acetabular cup loosening and 1 late infection. 3 hips were revised for a periprosthetic femoral fracture requiring a femoral component revision. The average time to revision was 51.6 (range 0–148) months. Kaplan-Meier survivorship analysis with an end point of revision for any reason demonstrated a survival rate of 97.4% at 10 years. Survival was 98.7% with revision for aseptic loosening as the endpoint. Conclusions: The outcomes of a cementless grit-blasted and MAO-coated tapered-wedge stem of THA were excellent to satisfactory after a follow-up of at least 10 years.

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Comparison of Postoperative Infection-Related Complications between Cemented and Cementless Hemiarthroplasty in Elderly Patients: A Meta-Analysis

Cited by 10 publications

References 30 publications

Comparison Between Cemented and Uncemented Hemiarthroplasty in Patients With Femoral Neck Fractures: A Systematic Review and Meta-analysis

Comparison Between Cemented and Uncemented Hemiarthroplasty in Patients With Femoral Neck Fractures: A Systematic Review and Meta-analysis

Is Cemented Bipolar Hemiarthroplasty Good Choice for Unstable Intertrochanteric Fractures in Elderly: Multicenteric Prospective Study at Karachi

Minimum 10-year follow-up of micro-arc oxidation coating on a cementless grit-blasted tapered-wedge stem of total hip arthroplasty: a multicentre study

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