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 German Arthroplasty Registry (EPRD). JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY, 24 (1): 9. ISSN 1590-9921, 1590-9999
Full text not available from this repository. (Request a copy)Abstract
BackgroundFemoral 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.MethodsData 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.ResultsExamination 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, while 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)].ConclusionFor 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, but without statistically significant results. Based on the present results, with knowledge of prevention measurements and correct cementation technique, cemented HA should be preferred when using HA in the treatment of femoral neck fractures.Trail registration: The study design of the German Arthroplasty Registry was approved by the University of Kiel (ID: D 473/11).Level of Evidence: Level III, Prognostic.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | UNCEMENTED HEMIARTHROPLASTY; PERIOPERATIVE MORTALITY; DISPLACED FRACTURE; HIP FRACTURE; RISK; FIXATION; Femoral neck fracture; Hemiarthroplasty; Embolism; Revision; Arthroplasty registry; Cementing |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Unfallchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Mar 2024 09:47 |
| Last Modified: | 12 Mar 2024 09:47 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59690 |
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