Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Sep 30;15(1):447.
doi: 10.1186/s13018-020-01980-4.

Cemented versus uncemented total hip replacement for femoral neck fractures in elderly patients: a retrospective, multicentre study with a mean 5-year follow-up

Shuai Mao  1 , Baomin Chen  1 , Ying Zhu  2 , Liang Qian  3 , Jinluan Lin  4 , Xinchao Zhang  5 , Weiguang Yu  6 , Guowei Han  7
Affiliations
Multicenter Study

Cemented versus uncemented total hip replacement for femoral neck fractures in elderly patients: a retrospective, multicentre study with a mean 5-year follow-up

Shuai Mao et al. J Orthop Surg Res. .

Abstract

Background: Cemented or uncemented total hip replacement (CTR or UTR) for femoral neck fractures (AO/OTA type 31B/C) is a relatively common procedure in elderly individuals. The recent literature is limited regarding long-term outcomes following CTR versus UTR in the Asian population.

Methods: Using our institutional database, we performed long-term outcome analysis on 268 patients with femoral neck fractures (AO/OTA type 31B/C) who had undergone a primary UTR or CTR (CTR: n = 132, mean age, 67.43 ± 6.51 years; UTR: n = 136, mean age, 67.65 ± 6.13 years) during 2007-2014, and these patients were followed until 2019. Follow-up occurred 1, 3, 6, and 12 months postoperatively and yearly thereafter. The primary endpoint was the Harris hip score (HHS); the secondary endpoint was the incidence of orthopaedic complications.

Results: The mean follow-up time was 62.5 months (range, 50.1-76.1 months). At the final follow-up, the HHS was 79.39 ± 16.92 vs 74.18 ± 17.55 (CTR vs UTR, respectively, p = 0.011). Between-group significant differences were observed regarding the incidence of prosthesis revision, prosthesis loosening, and periprosthetic fracture (7.6% [95% CI, 6.4-8.2] for CTR vs 16.9% [95% CI, 14.7-17.3] for UTR, p = 0.020; 9.8% [95% CI, 8.3-10.7] for CTR vs 19.9% [95% CI, 18.2-20.9] for UTR, p = 0.022; 5.3% [95% CI, 4.4-6.7] for CTR vs 13.2% [95% CI, 12.1-13.8] for UTR, p = 0.026, respectively).

Conclusion: CTR showed superiority to UTR by improving the HHS and decreasing the incidence of orthopaedic complications. Our findings need to be confirmed in a prospective, randomized controlled study to verify whether they can be applicable to a broader population.

Keywords: Cemented; Femoral neck fracture; Prosthesis revision; Total hip replacement; Uncemented.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram demonstrating methods for identification and exclusion of studies comparing the long-term outcomes of patients with femoral neck fractures (AO/OTA type 31B/C) treated with primary unilateral cemented or uncemented total hip replacement (CTR or UTR, respectively)
Fig. 2
Fig. 2
Kaplan–Meier survival curve for both groups with prosthesis revision for any reason as the endpoint
Fig. 3
Fig. 3
Kaplan–Meier survival curve for both groups with prosthesis loosening as endpoint
Fig. 4
Fig. 4
Kaplan–Meier survival curve for both groups with periprosthetic fracture as endpoint
See this image and copyright information in PMC

References

    1. Dimitriou D, Helmy N, Hasler J, Flury A, Finsterwald M, Antoniadis A. The role of total hip arthroplasty through the direct anterior approach in femoral neck fracture and factors affecting the outcome. J Arthroplasty. 2019;34(1):82–87. doi: 10.1016/j.arth.2018.08.037. - DOI - PubMed
    1. Assi CC, Barakat HB, Caton JH, Najjar EN, Samaha CT, Yammine KF. Mortality rate and mid-term outcomes of total hip arthroplasty using dual mobility cups for the treatment of femoral neck fractures in a Middle Eastern population. J Arthroplasty. 2019;34(2):333–337. doi: 10.1016/j.arth.2018.10.030. - DOI - PubMed
    1. Rashed RA, Sevenoaks H, Shabaan AM, Choudry QA, Hammad AS, Kasem MS, et al. Functional outcome and health related quality of life after dual mobility cup total hip replacement for displaced femoral neck fractures in middle aged Egyptian patients. Injury. 2018;49(3):667–672. doi: 10.1016/j.injury.2018.01.006. - DOI - PubMed
    1. Hernandez NM, Chalmers BP, Perry KI, Berry DJ, Yuan BJ, Abdel MP. Total hip arthroplasty after in situ fixation of minimally displaced femoral neck fractures in elderly patients. J Arthroplasty. 2018;33(1):144–148. doi: 10.1016/j.arth.2017.07.035. - DOI - PubMed
    1. Boukebous B, Boutroux P, Zahi R, Azmy C, Guillon P. Comparison of dual mobility total hip arthroplasty and bipolar arthroplasty for femoral neck fractures: a retrospective case-control study of 199 hips. Orthop Traumatol Surg Res. 2018;104(3):369–375. doi: 10.1016/j.otsr.2018.01.006. - DOI - PubMed

Publication types