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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 6/2009

01-06-2009 | Trauma Surgery

High revision rate after treatment of femoral neck fractures with an optionally (un)cemented stem

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2009

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Abstract

Background

The advantages of uncemented and cemented components in hip arthroplasty have been subject of debate. We have studied on a hemiprosthesis, which can be optionally implanted with or without cement. Since the stem geometry and surface in cemented arthroplasty differs from the uncemented one and cannot be fused into one general design, we hypothesised that this hemiprosthesis used without cement has a considerable high revision rate, based on aseptic loosening.

Methods

A hemiprosthesis, which is designed for both cemented and uncemented fixation, was used (Conquest, Smith&Nephew). Preoperatively, the choice of whether to use cement or not was based on the shape and bone quality of the femoral canal. Revision rate and indication, mortality, perioperative complications and radiographic features of 151 consecutive hips in 146 patients were evaluated.

Results

Twenty-three stems (15%) were implanted with cement and 128 (85%) without. After a mean follow-up of 2 years, a revision rate of 8.6% and a survival percentage of 90% (CI 85–95) were observed. Twelve uncemented stems warranted revision, compared with one cemented stem. Revision because of aseptic loosening was necessary in 7 (6%) stems, all uncemented. No differences in operation-related mortality and morbidity were observed.

Conclusion

Because of the rather high revision rate, the authors advice not to use this hemiprosthesis without cement.
Literature
1.
Parker MJ, Gurusamy K (2006) Arthroplasties (with or without bone cement) for proximal femoral fractures in adults (review). Cochrane Database 19(3):CD001706
2.
Morshed S, Bozic KJ, Ries MD, Malchau H, Colford JM Jr (2007) Comparison of cemented and uncemented fixation in total hip replacement. Acta Orthop 78(3):315–326PubMedCrossRef
3.
Leighton RK, Schmidt AH, Collier P, Trask K (2007) Advances in the treatment of intracapsular hip fractures in the elderly. Injury 38(S3):S24–S34PubMedCrossRef
4.
Foster AP, Thompson NW, Wong J, Charlwood AP (2005) Periprosthetic femoral fractures-a comparison between cemented and uncemented hemiarthroplasties. Injury 36(3):424–429PubMedCrossRef
5.
Emery RJ, Broughton NS, Desai K, Bulstrode CJ, Thomas TL (1991) Bipolar hemiarthroplasty for subcapital fracture of the femoral neck. A prospective randomised trial of cemented thompson and uncemented Moore stems. J Bone Joint Surg (Br) 73:322–324
6.
Sonne-Holm S, Dyrbye M, Walter S, Jensen JS (1983) Bone scintigraphy in Moore hemiarthroplasty with and without cement following femoral neck fractures. A controlled study. Acta Orthop Scand 54:194–197PubMedCrossRef
7.
Dorr LD, Glousman R, Sew Hoy ALS, Vanis R, Chandler R (1986) Threatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty. J. Arthroplasty 1:21–28PubMedCrossRef
8.
Lo WH, Chen WM, Huang CK, Chen TH, Chiu FY, Chen CM (1994) Bateman Bipolar hemiarthroplasty for displaced intracapsular femoral neck fractures uncemented versus cemented. Clin Orthop 302:75–82PubMed
9.
Faraj AA, Branfoot T (1999) Cemented versus uncemented Thompson’s prostheses: a functional outcome study. Injury 30:671–675PubMedCrossRef
10.
Min B, Longjohn DB, Dorr LD, Wan Z (2000) Radiographic comparison of diaphyseal grit blasted with smooth surface stems by matched pair analysis. Clin Orthop 381:156–167PubMedCrossRef
11.
Hinrichs F, Kühl M, Boudriot U, Griss P (2003) A comparative clinical outcome evaluation of smooth (10–13 year results) versus rough surface finish (5–8 year results) in an otherwise identically designed cemented titanium alloy stem. Arch Orthop Trauma Surg 123:268–272PubMedCrossRef
12.
Effenberger H, Heiland A, Ramsauer T, Plitz W, Dorn U (2001) A model for assessing the rotational stability of uncemented femoral implants. Arch Orthop Trauma Surg 121:60–64PubMedCrossRef
13.
Pabinger C, Kröner A, Lange A, Eyb R (2004) Cemented titanium stems show high migration: transprosthetic drainage system has no advantage over third-generation cementation technique. Arch Orthop Trauma Surg 124:489–494PubMedCrossRef
14.
Bombelli R (1983) Osteoarthritis of the hip: classification and pathogenesis: the role of osteotomy as a consequent therapy, 2nd ed. edn. Springer, New York, pp 89–108
15.
Noble PC, Box GG, Kamaric E, Fink MJ, Alexander JW, Tullos HS (1995) The effect of aging on the shape of the proximal femur. Clin Orthop 316:31–44PubMed
16.
Parvizi J, Holiday AD, Ereth MH, Lewallen DG (1999) Sudden death during primary hip arthroplasty. Clin Orthop 369:39–48PubMedCrossRef
17.
Lennox IA, McLauchlan J (1993) Comparing the mortality and morbidity of cemented and uncemented hemiarthroplasties. Injury 24(3):185–186PubMedCrossRef
18.
Meding JB, Ritter MA, Keating EM, Faris PM (1997) Comparison of collared and collarless femoral components in primary uncemented total hip arthroplasty. J Arthroplasty 12:273–280PubMedCrossRef
Metadata
Title
High revision rate after treatment of femoral neck fractures with an optionally (un)cemented stem
Publication date
01-06-2009
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 6/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-008-0697-4

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