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Cemented hemiarthroplasty deemed safe for patients with ischemic heart disease

No differences seen in perioperative mortality or deep infection rates among patients treated for femoral neck fractures.

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SEOUL — Korean researchers reported nearly equal complication rates in patients with ischemic heart disease treated with cemented hemiarthroplasty for a femoral neck fracture and in those who had no signs of heart disease.

Still, research must continue to ensure that the polymethylmethacrylate (PMMA) in the cement does not pose a risk factor for other vascular events, said Suk Ku Han, MD, who presented the findings at the 15th Triennial Congress of the Asia Pacific Orthopaedic Association, here.

Researches at The Catholic University of Korea and Kangnam St. Mary's Hospital in Seoul performed cemented hemiarthroplasties for displaced femoral neck fractures on 158 consecutive patients; 127 patients were included in the investigation. The retrospective study included 36 patients with ischemic heart disease and 91 patients age-matched control patients who did not have the disease. The average age for patients in both groups was 77.5 years and 76.4 years, respectively; the average follow-up was 9 months, Han said.

Nine patients (25%) in the ischemia group had stable or unstable angina, and 27% had myocardial infarctions. Patients who had congenital heart failure or arrhythmia were excluded from the study.

"The goal of our study was to focus on the cardiovascular and general vascular function of these patients to see if the cemented hemiarthroplasty had an effect," Han said.

The incidence of cerebral infarction and myocardial infarction was higher in patients with heart disease. Also, the incidence of hip dislocation as the result of weakness from a past ischemic brain lesion was higher among patients with heart disease, he said.

In addition, patients with ischemic heart disease had a higher incidence of diabetes mellitus, hypertension and past episodes of brain ischemia.

However, "We saw no difference in perioperative mortality rate, deep infection rate, or incidence of pulmonary embolism or deep venous thrombosis among the two groups," Han said.

For more information:

• Han SK. Cemented hemiarthroplasty for treatment of femoral neck fractures in patients with ischemic heart disease. F034-4. Presented at the 15th Triennial Congress of the Asia Pacific Orthopaedic Association. Sept. 9-13, 2007. Seoul.