Cemented Versus Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures: A Prospective Trial with Two Years Follow-Up

Igor Movrin

Department of Traumatology, University Medical Centre Maribor, Slovenia

^*Correspondance to: Igor Movrin 

 PDF  Full Text DOI: 10.25107/2474-1647.2097

Abstract

Introduction: The optimal treatment for elderly patients remains controversial regarding the use of cement when treating displaced femoral neck fractures with hemiarthroplasty. Previous randomized trials comparing cemented (CHA) and Uncemented Hemiarthroplasty (UCH) have conflicting results. We conducted a prospective trial to compare cemented versus uncemented bipolar hemiarthroplasty in any differences in intraoperative events, differences in functional outcomes and the rates of postoperative complications between these two groups.Material and
Methods: This prospective study compares data of 135 patients aged ≥ 76 years who underwent bipolar hemiarthroplasty for displaced femoral neck fracture using a cemented (n=56) or uncemented (n=79) bipolar hemiarthroplasty with a 2 year follow up.Results: The cemented and uncemented group did not differ significantly in terms of age, sex, and comorbidities. The cemented group had significantly longer operating time (p=0.038) and greater intraoperative blood lose (p=0.024). There were 6 (10.7%) events of intraoperative drop of the SaO2 in the cemented group and no such events in the UCH group. Despite no significant differences between the 2 groups, we found that the CHA group was associated with higher early postoperative mortality (8.9% versus 3.8% in the UCH group). Intraoperative fracture occurred in 2 patients (2.5%) in the UCH group. During the 2-year follow-up period there were no significant differences between the groups regarding the rate of dislocation or rate of postoperative periprosthetic fracture. There was a trend towards better postoperative functional recovery at 6 weeks for CHA group, although the mean Harris hip score at the end of 2 years was almost the same.Conclusion: Both CHA and UCH are acceptable methods for treating displaced femoral neck fractures. However, based on our results it seems that perioperative cardiovascular disturbances may be less frequent and consequently early mortality may be lower with UCH. Therefore, UCH is particularly appropriate for elderly patients with pre-existing cardiovascular comorbidities.

Keywords

Femoral neck fracture; Hemiarthroplasty; Cemented hemiarthroplasty; Uncemented hemiarthroplasty

Cite the article

Movrin I. Cemented Versus Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures: A Prospective Trial with Two Years Follow-Up. Clin Surg. 2018; 3: 2097.