Uncemented hip hemiarthroplasty associated with increased fracture risk, complications
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TAMPA, Fla. —Despite decreased operative times, uncemented hip hemiarthroplasty was associated with increased risk of fractures and complications compared with cemented hip hemiarthroplasty, results showed.
“While there is a consensus on treatment of displaced femoral neck fractures in the elderly being hemiarthroplasty, there is still debate regarding whether to cement or not,” Paulo Castaneda, MD, said in his presentation at the Orthopaedic Trauma Association Annual Meeting.
In a retrospective chart review, Castaneda and colleagues analyzed 3,820 patients (mean age of 81 years) who sustained an intracapsular femoral neck fracture and underwent either cemented hip hemiarthroplasty (HHA) (n = 382) or uncemented HHA (n = 3,438) from 2009 to 2017. According to the abstract, outcome measures included intraoperative and postoperative fractures, operative time, infection, dislocation, reoperation and mortality.
Overall fracture incidence was 11.7% in the uncemented HHA group with an intraoperative fracture rate of 2.8% and a postoperative fracture rate of 8.9%. Fracture rates were lower in the cemented HHA group with a 6.5% overall fracture rate, a 0.8% intraoperative fracture rate and a 5.8% postoperative fracture rate.
Castaneda also noted total complications and reoperation rates were higher in the uncemented group compared with the cemented group. Mean operative time was 59 minutes in the uncemented HHA group and 86 minutes in the cemented HHA group.
“We should all be doing in our hospital systems more cemented hemiarthroplasty for our elderly patients,” Castaneda said. “This study underscores the importance of critical evaluation of evidence and the applicability of literature-guided practices,” he concluded.
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Castaneda P, et al. Paper 67. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 12-15, 2022; Tampa, Fla.
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