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 to cite this document:

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

DOI to cite this document:

10.5283/epub.53873 Copy

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

License: Creative Commons Attribution 4.0 PDF - Published Version (1MB)

Date of publication of this fulltext: 27 Feb 2023 10:17

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Details

Item type:	Article
Open Access Type:	DEAL (Springer Gold)
Journal or Publication Title:	Journal of Orthopaedics and Traumatology
Publisher:	SPRINGER
Place of Publication:	NEW YORK
Volume:	24
Page Range:	p. 9
Date:	22 February 2023
Institutions:	Medicine > Lehrstuhl für Unfallchirurgie
Identification Number:	Value Type 10.1186/s10195-023-00689-4 DOI
Keywords:	UNCEMENTED HEMIARTHROPLASTY; PERIOPERATIVE MORTALITY; DISPLACED FRACTURE; HIP FRACTURE; RISK; FIXATION; Femoral neck fracture; Hemiarthroplasty; Embolism; Revision; Arthroplasty registry; Cementing
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Partially
Item ID:	53873

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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 ...

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.

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Metadata last modified: 16 Jan 2025 15:00

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