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)

URN zum Zitieren dieses Dokuments:

urn:nbn:de:bvb:355-epub-538733 Copy

DOI zum Zitieren dieses Dokuments:

10.5283/epub.53873 Copy

Szymski, Dominik ; Walter, Nike ; Krull, Paula ; Melsheimer, Oliver ; Grimberg, Alexander ; Alt, Volker ; Steinbrück, Arnd ; Rupp, Markus

Lizenz: Creative Commons Namensnennung 4.0 International PDF - Veröffentlichte Version (1MB)

Veröffentlichungsdatum dieses Volltextes: 27 Feb 2023 10:17

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Alternative Links zum Volltext:DOIVerlag

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Details

Dokumentenart:	Artikel
Open Access Art:	DEAL (Springer Gold)
Höhe Gebühr (aus OpenAPC):	2153.21
Institution der Zahlung:	Regensburg U
Titel eines Journals oder einer Zeitschrift:	Journal of Orthopaedics and Traumatology
Verlag:	Springer
Band:	24
Seitenbereich:	S. 9
Datum:	22 Februar 2023
Institutionen:	Medizin > Lehrstuhl für Unfallchirurgie
Identifikationsnummer:	Wert Typ 10.1186/s10195-023-00689-4 DOI
Stichwörter / Keywords:	Femoral neck fracture, Hemiarthroplasty, Embolism, Revision, Arthroplasty registry, Cementing
Dewey-Dezimal-Klassifikation:	600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
Status:	Veröffentlicht
Begutachtet:	Ja, diese Version wurde begutachtet
An der Universität Regensburg entstanden:	Zum Teil
Dokumenten-ID:	53873

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Zusammenfassung

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 ...

Zusammenfassung

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, 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)].
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, 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.

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