Systematic review of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures in older patients

Luo, Xiangping; He, Shunqing; Li, Zhaojun; Huang, Deijia

doi:10.1007/s00402-011-1436-9

Cited by 78 publications

(69 citation statements)

References 31 publications

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“…Different operative techniques are described in the literature. However, some questions concerning benefits of different approaches, complication rates, fixation (cementless vs cemented), implant design (bipolar vs monopolar) and others are not completely resolved [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases

Biber

Brem

Singler³

et al. 2012

International Orthopaedics (SICOT)

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Purpose Hemiarthroplasty (HA) is an established treatment for femoral neck fractures of the elderly. Several surgical approaches are currently used including dorsal and transgluteal. It is still unclear whether one approach may be advantageous. We compared early complication rates after dorsal and transgluteal approaches. Methods We retrospectively analysed a cohort including 704 consecutive patients who received HA for femoral neck fracture; 212 male and 492 female patients were included, and the mean age was 80.4 years (SD 9.8 years). In 487 patients a dorsal and in 217 a transgluteal approach was chosen. In all patients an Excia® stem with selfcentring bipolar head manufactured by Aesculap (Tuttlingen, Germany) was used. We evaluated early postoperative complications including dislocation, infection, haematoma, seroma and perioperative fracture. Complication rates after dorsal and transgluteal approaches were calculated and compared by the chi-square test.Results After a dorsal approach 10.5 % [confidence interval (CI) 7.7-13.2 %] of the patients suffered one or more early complications. Following a transgluteal approach this proportion was 9.7 % (CI 5.7-13.6 %), which was not significantly different (p00.75). The predominant complication after a dorsal approach was dislocation (3.9 %; CI 2.2-5.6 %). The dislocation rate after a transgluteal approach was significantly lower (0.5 %; CI 0-1.4 %). Postoperative haematoma however was seen after a transgluteal approach in 5.5 % (CI 2.5-8.6 %), which was significantly more frequent than after a dorsal approach (1.2 %; CI 0.2-2.2 %). The frequency of the other types of complications did not significantly differ. Conclusions The rate of early surgical complications after dorsal and transgluteal approaches is not significantly different. However, the dorsal approach predisposed to dislocation, whereas the transgluteal approach predisposed to haematoma.

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Section: Introductionmentioning

confidence: 99%

Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases

Biber

Brem

Singler³

et al. 2012

International Orthopaedics (SICOT)

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“…Treatment options include THA and bipolar hemiarthroplasty [2,12,18,26]. The optimal surgical treatment of displaced femoral neck fractures is still debated.…”

Section: Discussionmentioning

confidence: 99%

“…No unipolar components were used during the study period for the indication of a displaced femoral neck fracture. Developments in implant fixation techniques have led to the use of uncemented stems in hemiarthroplasties, although studies have shown advantages in the survival with cemented femoral components for this elderly cohort [6,18,26,27]. Second, our intention was not to compare cemented bipolar hemiarthroplasties with THAs.…”

Section: Discussionmentioning

confidence: 99%

“…Controversy exists regarding the relative merits of hemiarthroplasty versus THA for patients with displaced femoral neck fractures, with some data supporting improved function in selected patients treated with THA [1,3,4,6,8,10,13,17,18,26]. It is important to understand short-and mid-term clinical results and the long-term likelihood of reoperation or revision of two commonly used treatment options, THA and bipolar hemiarthroplasty [12,18,26].…”

Section: Introductionmentioning

confidence: 99%

“…It is important to understand short-and mid-term clinical results and the long-term likelihood of reoperation or revision of two commonly used treatment options, THA and bipolar hemiarthroplasty [12,18,26].…”

Section: Introductionmentioning

confidence: 99%

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Cemented Bipolar Hemiarthroplasty Provides Definitive Treatment for Femoral Neck Fractures at 20 Years and Beyond

Roth

Abdel

Harmsen

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Displaced femoral neck fractures frequently are treated with bipolar hemiarthroplasties. Despite the frequency with which bipolar hemiarthroplasty is used to treat these fractures, there are few long-term data. Questions/purposes We sought to evaluate (1) the cumulative incidence of revision for any reason of bipolar hemiarthroplasties at 20 years, and the proportion of patients who lived more than 20 years who still have the prosthesis in situ from the index arthroplasty, (2) the cumulative incidence of aseptic loosening at 20 years, and (3) the Harris hip score of the surviving patients at long term.Methods We performed 376 cemented bipolar hemiarthroplasties for displaced femoral neck fractures in 359 patients between 1976 and 1985. At a minimum of followup of 20 years (mean, 24 years; range, 20-31 years), 339 of 359 patients (94%) were deceased, leaving 20 patients in the study group. Of those, one patient was confirmed to be lost to followup and two others had radiographic followup only. Three hundred fifty-nine patients (99.2%) (376 of the original 379 hips) were followed until death, revision of the hemiarthroplasty, or for at least 20 years (of clinical followup). Bipolar hemiarthroplasty was performed for displaced femoral neck fractures. Cemented fixation was the standard of care between 1976 and 1985 at our institution. The mean age of the patients at the time of surgery was 79 years (range, 60-99 years). The cumulative incidence of revision, estimated with death as a competing risk, and radiographs were evaluated for signs of aseptic loosening by a surgeon not involved in the clinical care of the patients. Clinical function was evaluated with the Harris hip score. The mean age of the patients at the time of surgery was 79 years. Results The 20-year cumulative incidence of revision for any reason was 3.5% (95% CI, 1.6%-5.3%). Of the 20 patients who survived more than 20 years, seven had the implant intact. The 20-year cumulative incidence of revision for aseptic loosening was 1.4% (95% CI, 0.2%-2.6%). The mean Harris hip score in patients who were still living and patient who did not have revision surgery was 63 ± 22, however 13 of the 20 patients had undergone revision surgery. Conclusions The long-term survivorship of bipolar hemiarthroplasty prostheses used to treat displaced femoral neck fractures in the elderly was high, and the procedure can be considered definitive for the majority of elderly patients with a femoral neck fracture. In this series, 6%

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Primary Arthroplasty for Fractures of the Proximal Femur

D’sa

Mohanty

2022

Handbook of Orthopaedic Trauma Implantology

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Systematic review of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures in older patients

Cited by 78 publications

References 31 publications

Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases

Dorsal versus transgluteal approach for hip hemiarthroplasty: an analysis of early complications in seven hundred and four consecutive cases

Cemented Bipolar Hemiarthroplasty Provides Definitive Treatment for Femoral Neck Fractures at 20 Years and Beyond

Primary Arthroplasty for Fractures of the Proximal Femur

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