Szymski, Dominik and Walter, Nike and Krull, Paula and Melsheimer, Oliver and Grimberg, Alexander and Alt, Volker and Steinbrueck, Arnd and Rupp, Markus (2023) Aseptic revisions and pulmonary embolism after surgical treatment of femoral neck fractures with cemented and cementless hemiarthroplasty in Germany An analysis from the Germany Arthroplasty Registry (EPRD). ORTHOPADIE, 52 (8). pp. 670-676. ISSN 2731-7145, 2731-7153
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Background: Femoral neck fractures (FNF) are among the most common fractures in Germany and are often treated by hemiarthroplasty (HA). The aim of this study was to compare the occurrence of aseptic revisions after cemented and uncemented HA for the treatment of FNF. Secondly, the rate of pulmonary embolism was investigated.Methods: Data collection for this study was performed using the German Arthroplasty Registry (EPRD). HAs after FNF were divided into subgroups stratified by stem fixation (cemented vs uncemented) and paired according to age, sex, BMI, and the Elixhauser score using Mahalanobis distance matching.Results: Examination of 18,180 matched cases showed a significantly increased rate of aseptic revisions in uncemented HA (p < 0.0001). After 1 month 2.5% of HAs with uncemented stems required an aseptic revision, whereas 1.5% were reported in cemented HA. After 1 and 3 years' follow-up 3.9% and 4.5% of uncemented HA and 2.2% and 2.5% of cemented HA needed aseptic revision surgery. In particular, the proportion of periprosthetic fractures was increased in cementless implanted HA (p < 0.0001). During in-patient stays, pulmonary emboli occurred more frequently after cemented HA (0.81% vs 0.53% in cementless HA [OR: 1.53; p = 0.057]).Conclusion: For uncemented hemiarthroplasties a statistically significantly increased rate of aseptic revisions and periprosthetic fractures was evident within a time period of 5 years after implantation. During the in-hospital stay, patients with cemented HA experienced an increased rate of pulmonary embolism compared with patients with cementless HA, but this difference was not statistically significant. Based on the present results, with knowledge of prevention measures and the correct cementation technique, the use of cemented HA should be preferred in the treatment of femoral neck fractures.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | UNCEMENTED HEMIARTHROPLASTY; PERIOPERATIVE MORTALITY; DISPLACED FRACTURE; HIP FRACTURE; RISK; FIXATION; Cementation; Femur neck; Followup studies; Prostheses; Revision surgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Mar 2024 11:15 |
| Last Modified: | 13 Mar 2024 06:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59461 |
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