A PROSPECTIVE STUDY OF FUNCTIONAL OUTCOMES IN CEMENTED VS. UNCEMENTED HEMIARTHROPLASTY IN FEMORAL NECK FRACTURES IN GERIATRIC AGE.

Introduction: The optimum treatment choice for femoral neck fractures is often contested. In this study, we aimed to compare the functional outcome in geriatric patients who underwent either cemented or uncemented hemiarthroplasty in our department. Methods: This prospective study included patients who were scheduled to undergo hemiarthroplasty for femoral neck fracture in the Department of Orthopaedics, Hi-Tech Medical College, Bhubaneswar, Odisha. Two study groups were made. One group had patients who underwent uncemented hemiarthroplasty and the second group had patients who underwent cemented hemiarhtroplasty. Surgery related information was collected from the operative notes of the surgeon. Post-operative complications, Visual Analogue Scale (VAS) scores and Harris Hip Score (HHS) were noted during the follow up period. Results: There were 30 patients in the uncemented group and 31 in the cemented group. All the baseline demographic and clinical variables were similar in both the study groups. Mean intraoperative blood loss and operative time was significantly higher among the patients who underwent cemented hemiarthroplasty as compared to uncemented group. Mean VAS score at the first month and sixth month follow up was significantly higher among patients in the uncemented group as compared to cemented group. Functional outcome was not significantly different according to the HHS performed 6 months post-operatively. Conclusions: Patients in the cemented group had a higher intra-operative blood loss and longer operative time. However, the pain score on the VAS were significantly lower at first and sixth month follow up. Functional outcomes were not significantly different between the two study groups.

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Comparing outcomes in cemented vs uncemented hemiarthroplasty in femoral neck fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20185338 ◽

2018 ◽

Vol 5 (1) ◽

pp. 152

Author(s):

Udit Kapoor ◽

Amit Chug ◽

Govind Baranwal ◽

Shaunak Patil ◽

Shubham Kumar

Keyword(s):

Femoral Neck ◽

Blood Loss ◽

Functional Outcome ◽

Operative Time ◽

Study Groups ◽

Femoral Neck Fractures ◽

Uncemented Hemiarthroplasty ◽

Operative Notes ◽

Uncemented Group

Background: The optimal treatment choice for femoral neck fractures is often debated. In this study, we aimed to compare the functional outcome in elderly patients who underwent either cemented or uncemented hemiarthroplasty in our department.Methods: This prospective study included patients who were scheduled to undergo hemiarthroplasty for femoral neck fracture in the Department of Orthopedics, Dr DY Patil University School of Medicine, Navi Mumbai. Two study groups were made. One group had patients who underwent uncemented hemiarthroplasty and the second group had patients who underwent cemented hemiarhtroplasty. Surgery related information was collected from the operative notes of the surgeon. Post-operative complications, Visual Analogue Scale (VAS) scores and Harris Hip Score (HHS) were noted during the follow up period.Results: There were 30 patients in the uncemented group and 31 in the cemented group. All the baseline demographic and clinical variables were similar in both the study groups. Mean intraoperative blood loss and operative time was significantly higher among the patients who underwent cemented hemiarthroplasty as compared to uncemented group. Mean VAS score at the first month and sixth month follow up was significantly higher among patients in the uncemented group as compared to cemented group. Functional outcome was not signicantly different according to the HHS performed 6 months post-operatively.Conclusions: Patients in the cemented group had a higher intra-operative blood loss and longer operative time. However, the pain score on the VAS were significantly lower at first and sixth month follow up. Functional outcomes were not significantly different between the two study groups.

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Femoral neck system versus inverted cannulated cancellous screw for the treatment of femoral neck fractures in adults: a preliminary comparative study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02659-0 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yunfeng Tang ◽

Zhen Zhang ◽

Limin Wang ◽

Wei Xiong ◽

Qian Fang ◽

...

Keyword(s):

Femoral Head ◽

Femoral Neck ◽

Blood Loss ◽

Operative Time ◽

Length Of Hospital Stay ◽

Femoral Neck Fractures ◽

Intraoperative Blood Loss ◽

Incision Length ◽

Cancellous Screws

Abstract Background The femoral neck system (FNS) may be a valid alternative for treating femoral neck fractures, but few studies have compared the outcomes between FNS and cannulated cancellous screws. This study aimed to compare the clinical efficacy and complications of FNS with those of inverted cannulated cancellous screws (ICCS) for the treatment of femoral neck fractures in adults. Methods This retrospective study evaluated patients with femoral neck fractures who underwent FNS or ICCS internal fixation between June 2019 and January 2020. The operative time, intraoperative blood loss, number of fluoroscopies, length of surgical incision, length of hospital stay, time to fracture healing, and other indicators were compared between the two groups. The incidence of complications such as nonunion, avascular necrosis of the femoral head, loosening of the internal fixation, and shortening of the femoral neck during follow-up was also assessed in both groups. Results Among the 92 patients included, 47 and 45 patients were categorized into the FNS and ICCS groups, respectively. Follow-up ranged from 14 to 24 months. There were no significant between-group differences in sex, age, side of the injured limb, and type of fracture and in operative time, intraoperative blood loss, incision length, and length of hospital stay (all P > 0.05). The incidence of complications such as fracture nonunion, avascular necrosis of the femoral head, and screw loosening was also comparable between the two groups. However, the number of fluoroscopies was significantly lower in the FNS group than in the ICCS group (P < 0.05). The fracture healing time was also significantly lower in the FNS group than in the ICCS group (P < 0.05). Furthermore, the femoral neck shortening and Harris hip score at the last follow-up were significantly better in the FNS group than in the ICCS group (P < 0.05). Conclusions FNS for femoral neck fractures improves hip functional recovery and reduces the femoral neck shortening rate and fluoroscopy exposure postoperatively. Thus, FNS can be an alternative to ICCS for the treatment of femoral neck fractures.

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Cemented versus cementless bipolar hemiarthroplasty for femoral neck fractures in the elderly

EFORT Open Reviews ◽

10.1302/2058-5241.6.200057 ◽

2021 ◽

Vol 6 (5) ◽

pp. 380-386

Author(s):

Ahmed Fikry Elmenshawy ◽

Khaled Hamed Salem

Keyword(s):

Femoral Neck ◽

Blood Loss ◽

Operative Time ◽

Treatment Options ◽

The Elderly ◽

Similar Rate ◽

Femoral Neck Fractures ◽

Bipolar Hemiarthroplasty ◽

Systemic Complications ◽

Uncemented Hemiarthroplasty

The management of femoral neck fractures remains controversial. Treatment options include a wide variety of internal fixation methods, unipolar or bipolar hemiarthroplasty or total hip replacement. We carried out a systematic review of the available literature to detect differences between cemented and cementless fixation of bipolar prostheses in treating femoral neck fractures in patients aged 60 years or older. Thirteen studies involving a total of 1561 bipolar hemiarthroplasties (770 cemented and 791 uncemented) were identified. Uncemented hemiarthroplasty was associated with significantly lower blood loss (p < 0.0001), shorter operative time (p < 0.0001), less infection (p = 0.03) and lower risk of heterotopic ossification (p = 0.007). On the other hand, patients with cemented hemiarthroplasty suffered significantly less postoperative thigh pain than those with cementless implantation (p < 0.00001). The existing evidence indicates that uncemented bipolar hemiarthroplasty offers shorter operative time, less blood loss, lower local complications and a similar rate of systemic complications and reoperations as compared to cemented implantation. Cite this article: EFORT Open Rev 2021;6:380-386. DOI: 10.1302/2058-5241.6.200057

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Cemented versus Uncemented Hemiarthroplasty for Femoral Neck Fractures in Patients with Neuromuscular Diseases: A Minimum of 2 Years Follow-Up Study

10.21203/rs.3.rs-510142/v1 ◽

2021 ◽

Author(s):

Yuchuan Wang ◽

Zhongzheng Wang ◽

Siyu Tian ◽

Zhanchao Tan ◽

Yanbin Zhu ◽

...

Keyword(s):

Femoral Neck ◽

Neuromuscular Diseases ◽

Femoral Neck Fractures ◽

Intraoperative Blood Loss ◽

Uncemented Hemiarthroplasty ◽

Duration Of Surgery ◽

The Mean ◽

Uncemented Group

Abstract Background The aim of this study is to compare the outcomes of cemented and uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular disease. Methods We reviewed 156 patients with neuromuscular disease who underwent hemiarthroplasty between 2015 and 2019. Patients were divided into cemented group (n = 105) and uncemented group (n = 51), with a minimum follow-up of 2 years. Factors including preoperative features, duration of surgery, intraoperative blood loss, complications, pain, Harris hip scores (HHS), and quality of life were compared across groups, and Kaplan-Meier curves were used to estimate survival. Results In the uncemented group, the mean duration of surgery was 16.0 minutes shorter (p = 0.001) and the mean intraoperative blood loss was 71.1 mL less (p = 0.01). Visual analog scales (VAS), HHS and European Quality of Life-5 Dimensions (EQ-5D) scores were not different between the groups. Despite a few potential trends, we did not observe a difference in complications such as periprosthetic fractures and dislocations. The rates of mortality were similar between groups (p=0.821). Conclusions Both arthroplasties may be used with good medium-term results in the treatment of femoral neck fractures in patients with neuromuscular diseases.

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Cemented versus uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular diseases: a minimum of 2 years’ follow-up study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02572-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yuchuan Wang ◽

Zhongzheng Wang ◽

Siyu Tian ◽

Zhanchao Tan ◽

Yanbin Zhu ◽

...

Keyword(s):

Femoral Neck ◽

Neuromuscular Diseases ◽

Femoral Neck Fractures ◽

Intraoperative Blood Loss ◽

Uncemented Hemiarthroplasty ◽

Duration Of Surgery ◽

The Mean ◽

Uncemented Group

Abstract Background The aim of this study was to compare the outcomes of cemented and uncemented hemiarthroplasty for femoral neck fractures in patients with neuromuscular disease. Methods We reviewed 156 patients with neuromuscular disease who underwent hemiarthroplasty between June 2015 and December 2019. Patients were divided into cemented group (n = 105) and uncemented group (n = 51), with a minimum follow-up of 2 years. Factors including preoperative features, duration of surgery, intraoperative blood loss, complications, pain, Harris hip scores (HHS), and quality of life were compared across groups, and Kaplan–Meier curves were used to estimate survival. Results In the uncemented group, the mean duration of surgery was 16.0 min. shorter (p = 0.001) and the mean intraoperative blood loss was 71.1 mL less (p = 0.01). Visual analog scales (VAS), HHS, and European Quality of Life-5 Dimensions (EQ-5D) scores were not different between the groups. Despite a few potential trends, we did not observe a difference in complications such as periprosthetic fractures and dislocations. The rates of mortality were similar between groups (p=0.821). Conclusions Both arthroplasties may be used with good medium-term results in the treatment of femoral neck fractures in patients with neuromuscular diseases.

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Cemented versus uncemented hemiarthroplasty for femoral neck fractures in elderly patients

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191784 ◽

2019 ◽

Vol 5 (3) ◽

pp. 458

Author(s):

Nikil Sanaba Paramesh ◽

Usman Taufiq

Keyword(s):

Femoral Neck ◽

Blood Loss ◽

Elderly Patients ◽

Operation Time ◽

Reoperation Rate ◽

Femoral Neck Fractures ◽

Intraoperative Blood Loss ◽

Cerebrovascular Complications ◽

Uncemented Hemiarthroplasty ◽

Hip Function

Background: Controversy still exists regarding using cemented or uncemented hemiarthroplasty for femoral neck fractures in elderly patients. The aim of this study is to compare the effectiveness and safety of the two surgical techniques in femoral neck fracture patients over 60 years old.Methods: We searched PUBMED from inception to December 2012 for relevant randomized controlled trials (RCTs). Outcomes of interest include postoperative hip function, residue pain, complication rates, mortality, reoperation rate, operation time and intraoperative blood loss. Odds ratios (OR) and weighted mean differences (WMD) from each trial were pooled using random-effects model or fixed-effects model given on the heterogeneity of the included studies.Results: Our control trial involved 132 patients (132 hips) who were eligible for the study. Our results demonstrate that cemented hemiarthroplasty is associated with better postoperative hip function (OR = 0.48, 95% CI, 0.31–0.76; p = 0.002), lower residual pain (OR = 0.43, 95%CI, 0.29–0.64; p<0.0001), less implant-related complications (OR = 0.15, 95%CI, 0.09–0.26; p<0.00001) and longer operation time (WMD = 7.43 min, 95% CI, 5.37–9.49 min; p<0.00001). No significant difference was observed between the two groups in mortality, cardiovascular and cerebrovascular complications, local complications, general complications, reoperation rate and intraoperative blood loss.Conclusions: Compared with uncemented hemiarthroplasty, the existing evidence indicates that cemented hemiarthroplasty can achieve better hip function, lower residual pain and less implant-related complications with no increased risk of mortality, cardiovascular and cerebrovascular complications, general complications, local complications and reoperation rate in treating elderly patients with femoral neck fractures.

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