Comparing Intraoperative Blood Loss in Cemented, Uncemented, and Hybrid Total Hip Replacement for Neck of Femur Fractures

Abstract

Background As the aging population increases, osteoporotic neck of femur fracture cases will continue to rise. Although hemiarthroplasty or half hip replacement is the treatment of choice in a majority of patients, a small but definite cohort of patients would need a total hip replacement. In these elderly patients who often have comorbidities, the use of cement to fix the prosthesis is often quoted as beneficial in view of perceived lower blood loss compared to uncemented fixation of the prosthesis. However, the cementation of the implant in itself has inherent problems. This study examined three modalities of fixation of a prosthesis for total hip replacement in the neck of femur fractures, namely, cemented, hybrid, and uncemented, and compared their relative intraoperative blood loss. Methodology This is a retrospective study with a follow-up of two years. Patients who presented to a level 1 trauma center in an inner city metropolitan with neck of femur fractures and were treated by total hip replacement were included in the study. Intraoperative blood loss was calculated using Nadler's formula. Results There was no statistical difference in intraoperative blood loss in either of the three groups of patients, namely, cemented, hybrid, or uncemented total hip replacement for neck of femur fractures. Conclusions Intraoperative blood loss should not influence the modality of prosthesis fixation for total hip replacement in neck of femur fractures.

Keywords: blood loss; cemented; fracture neck of femur; hybrid; intraoperative; total hip replacement; uncemented.

Figure 1. Comparison of perioperative blood loss between group 1 (cemented) and group 2 (hybrid) with group 3 (uncemented).

Figure 2. Comparison of perioperative blood loss between group 1 (cemented) and group 2 (hybrid) with group 3 (uncemented).