Conservative versus Operative Management of Femoral Neck Fractures in Patients on Long-Term Dialysis

Tzamaloukas, A H; Murphy, Gavin J.; Schaab, Peter C.; Worrel, R.V.

doi:10.1159/000185963

Cited by 7 publications

(2 citation statements)

References 5 publications

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“…Patients with ESRD are a challenging group, as they have higher postoperative morbidity and mortality after surgery for hip fractures. (3)(4)(5) The increased risk of complications and mortality may be due to the ESRD, complications of dialysis, (20,21) We aimed to assess the clinical outcomes of surgically treated hip fractures in patients undergoing chronic dialysis by comparing them against patients with similar renal and cardiovascular function who were not undergoing dialysis. Our study showed that the patients undergoing dialysis had decreased odds of renal-related complications.…”

Section: Discussionmentioning

confidence: 99%

Hip hemiarthroplasty for femoral neck fractures in end-stage renal disease patients on dialysis compared to patients with late-stage chronic kidney disease

Ding

Shinde

Tan

2019

smedj

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Section: Discussionmentioning

confidence: 99%

Hip hemiarthroplasty for femoral neck fractures in end-stage renal disease patients on dialysis compared to patients with late-stage chronic kidney disease

Ding

Shinde

Tan

2019

smedj

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“…The end-stage of renal disease, chronic hemodialysis, and transplantation failure may cause multiorgan insufficiency, metabolic imbalance, and a high risk of postoperative complications and mortality. Despite the high risk of complications, operative treatment of femoral neck fracture has been recommended in this group of patients (Tzamaloukas et al 1990). Pathology associated with hemodialysis may lead to early loosening of the implant because of poor bone quality or migration of amyloid deposits into the bone-implant interface (Crawford and Athanasou 1998).…”

Section: Discussionmentioning

confidence: 99%

Bipolar cemented hip hemiarthroplasty in patients with femoral neck fracture who are on hemodialysis is associated with risk of stem migration

2009

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Background and purpose Femoral neck fractures are considerably more common in patients on hemodialysis than in the general population. We determined the outcome of bipolar hemiarthroplasty for hip fracture in patients with long-term hemodialysis and compared it with that of a matched-paired group of patients with intact renal function.Methods We analyzed 26 bipolar hemiarthroplasties in 23 hemodialysed patients with a mean age of 56 (41–78) years who were followed for mean 3.6 (1–8) years. These cases were matched for age, sex, and BMI with 26 patients with femoral neck fractures and normal renal function. The mean follow-up time in the control group was 7 (5–10) years. As primary surgery for their femoral neck fracture, all patients had a bipolar hemiarthroplasty with a 28-mm metal-polyethylene internal articulation and a cemented stem.Results The mortality rate was 21% in the hemodialysed group and 4% in the control group (p = 0.005). The bipolar head migrated in 1 patient in the hemodialysed group but in none of the patients in the case-matched group. In the hemodialysed group, 8 stems migrated and 3 of these were revised, whereas in the control group 3 stems migrated and 2 were revised. The stem migration in the hemodialysed group was not preceded by the development of osteolysis or radiolucent lines at the bone-cement interface. The cumulative survival for prosthesis migration as endpoint was 44% at 5 years in the hemodialysed group and 96% in the control group (p = 0.03).Interpretation The main mode of failure of cemented bipolar hemiarthroplasties in hemodialysed patients is stem migration, due to failure of the bone-cement interface.

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Femoral neck fracture in end-stage renal disease treated with osteosynthesis

Wong

Lin

Chien

et al. 2012

Formosan Journal of Musculoskeletal Disorders

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Conservative versus Operative Management of Femoral Neck Fractures in Patients on Long-Term Dialysis

Cited by 7 publications

References 5 publications

Hip hemiarthroplasty for femoral neck fractures in end-stage renal disease patients on dialysis compared to patients with late-stage chronic kidney disease

Hip hemiarthroplasty for femoral neck fractures in end-stage renal disease patients on dialysis compared to patients with late-stage chronic kidney disease

Bipolar cemented hip hemiarthroplasty in patients with femoral neck fracture who are on hemodialysis is associated with risk of stem migration

Femoral neck fracture in end-stage renal disease treated with osteosynthesis

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