Infection after intracapsular femoral neck fracture – does antibiotic-loaded bone cement reduce infection risk after hemiarthroplasty and total hip arthroplasty?: data from the German Arthroplasty Registry

Bone & Joint Research

article

Dominik Szymski¹  Nike Walter¹  Paula Krull²  Oliver Melsheimer²  Alexander Grimberg²  Volker Alt¹  Arnd Steinbrueck²  Markus Rupp¹ 

[1] Department of Trauma Surgery, University Hospital Regensburg;Deutsches Endoprothesenregister gGmbH

关键词: Hip arthroplasty;    Hemiarthroplasty;    Bone cement;    Femoral neck;    Fracture;    Periprosthetic joint infection;    intracapsular femoral neck fractures;    antibiotic-loaded bone cements;    infections;    total hip arthroplasty (THA);    hemiarthroplasty;    comorbidities;    femoral neck fractures;    BMI;    cemented and uncemented hemiarthroplasties;    cemented and uncemented hemiarthroplasties;   

DOI  :  10.1302/2046-3758.125.BJR-2022-0314.R1

学科分类：骨科学

来源: British Editorial Society Of Bone And Joint Surgery

【 摘 要 】

AimsThe aim of this investigation was to compare risk of infection in both cemented and uncemented hemiarthroplasty (HA) as well as in total hip arthroplasty (THA) following femoral neck fracture.MethodsData collection was performed using the German Arthroplasty Registry (EPRD). In HA and THA following femoral neck fracture, fixation method was divided into cemented and uncemented prostheses and paired according to age, sex, BMI, and the Elixhauser Comorbidity Index using Mahalanobis distance matching.ResultsOverall in 13,612 cases of intracapsular femoral neck fracture, 9,110 (66.9%) HAs and 4,502 (33.1%) THAs were analyzed. Infection rate in HA was significantly reduced in cases with use of antibiotic-loaded cement compared with uncemented fixated prosthesis (p = 0.013). In patients with THA no statistical difference between cemented and uncemented prosthesis was registered, however after one year 2.4% of infections were detected in uncemented and 2.1% in cemented THA. In the subpopulation of HA after one year, 1.9% of infections were registered in cemented and 2.8% in uncemented HA. BMI (p = 0.001) and Elixhauser Comorbidity Index (p < 0.003) were identified as risk factors of periprosthetic joint infection (PJI), while in THA cemented prosthesis also demonstrated an increased risk within the first 30 days (hazard ratio (HR) = 2.73; p = 0.010).ConclusionThe rate of infection after intracapsular femoral neck fracture was statistically significantly reduced in patients treated by antibiotic-loaded cemented HA. Particularly for patients with multiple risk factors for the development of a PJI, the usage of antibiotic-loaded bone cement seems to be a reasonable procedure for prevention of infection.

【 授权许可】

CC BY-NC