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Uncemented stems cited as reoperation risk factor for elderly hemiarthroplasty patients
An analysis of data in the Norwegian and Swedish national registries indicated that the use of uncemented stems and a posterior surgical approach increased the risk of reoperation in patients older than 80 years who had hip fractures treated by hemiarthroplasty.
“Cemented stems and a direct lateral transgluteal approach reduced the risk of reoperation after hip fractures treated with hemiarthroplasty in patients over 75 years,” the authors wrote in the study abstract. “Men and younger patients had a higher risk of reoperation. For the age group 60 [years] to 74 years, there were no differences in risk in this material.”
Using information from the Norwegian Hip Fracture Register and the Swedish Hip Arthroplasty Register, investigators reviewed the cases of 33,205 patients older than 60 years who had hip fractures treated with hemiarthroplasty between 2005 and 2010. There were 13,828 patients older than 85 years, 16,121 patients between 75 years and 85 years and 3,256 patients aged 60 years to 74 years.
The investigators discovered that 1,164 patients underwent reoperation at a mean follow-up of 2.7 years. The average age was 84 years and most of the patients were women. According to the results, the oldest group studied had increased risk of reoperation for men and patients who underwent surgery with uncemented stems, a posterior approach and bipolar heads. The 75-to-85-year-old group had an increased risk of reoperation for men and patients who underwent surgery with uncemented stems. The youngest group studied had no risk factors for reoperation.
“The optimum choice of unipolar or bipolar hemiarthroplasty or total hip arthroplasty, based on patient characteristics, must be studied further,” the authors wrote in the study.
Disclosure: Rogmark is on the speakers bureau for Biomet and Stryker.