More complications in uncemented compared to cemented hemiarthroplasty for displaced femoral neck fractures: a randomized controlled trial of 201 patients, with one year follow-up

BMC Musculoskeletal Disorders

Keetie Kremers van de Hei¹  Sander Koëter¹  Anne J. H. Vochteloo²  Tim L. Molenaar³  Sophie Moerman³  Nina M. C. Mathijssen³  Dieu D. Niesten³  Wim E. Tuinebreijer⁴  Rob G. H. H. Nelissen⁵  Willard J. Rijnberg⁶  Roeland Riedijk⁷ 

[1] Canisius Wilhelmina Hospital;Centre for Orthopedic Surgery OCON;Department of Orthopaedics, Reinier de Graaf Group;Department of Surgery/Traumatology, Erasmus MC;Leiden University Medical Center;Rijnstate Hospital;Tergooi hospital;

关键词: Hip fracture;    Arthroplasty;    Bone cement;    Complication;   

DOI  :  10.1186/s12891-017-1526-0

来源: DOAJ

【 摘 要 】

Abstract Background It is unclear whether cemented or uncemented hemiarthroplasty is the best treatment option in elderly patients with displaced femoral neck fractures. Previous randomized trials comparing cemented and uncemented hemiarthroplasty have conflicting results. We conducted a randomized controlled trial to compare cemented and uncemented hemiarthroplasty. Methods This multicenter parallel-randomized controlled trial included patients of 70 years and older with a displaced femoral neck fracture (Garden type III or IV). Inclusion was between August 2008 and June 2012. Patients were randomized between a cemented hemiarthroplasty, type Müller Straight Stem or an uncemented hemiarthroplasty, type DB-10. Primary outcomes were complications, operation time, functional outcome (measured by Timed-Up-and-Go (TUG) and Groningen Activity Restriction Scale (GARS)) and mid-thigh pain. Health Related Quality of Life (HRQoL, expressed with the SF-12) was measured as an secondary outcome. Follow up was 1 year. Results In total 201 patients were included in the study (91 uncemented, 110 cemented hemiarthroplasties) The uncemented group showed more major local complications (intra- and postoperative fractures and dislocations) odds ratio (95% confidence interval) 3.36 (1.40 to 8.11). There was no difference in mean operation time (57.3 vs 55.4 min). There were no differences in functional outcomes (TUG 12.8 (9.4) vs. 13.9 (9.0), GARS 43.2 (19.7) vs. 39.2 (16.5)) and mid-thigh pain (18.6 vs 21.6%). Physical component SF-12 HRQoLwas lower in the uncemented group (30.3 vs. 35.3 p < 0.05 after six weeks, 33.8 vs 38.5 p < 0.05 after 12 weeks). Conclusion A cemented hemiarthroplasty in elderly patients with a displaced femoral neck fracture results in less complications compared to an uncemented hemiarthroplasty. Trial registration Netherlands Trial Registry; NTR 1508 , accepted date 27 okt 2008

【 授权许可】

Unknown