Displaced intracapsular neck of femur fractures: End result of 810 hydroxyapetite coated (HAC) uncemented hemiarthroplasties.
Damage. 2017 Apr;48(four):909-913
Authors: Nawaz SZ, Keightley AJ, Desai A, Granville-Chapman J, Elliott D, Newman Okay, Khaleel A
A Cochrane evaluate influenced new NICE pointers, which really useful surgeons: Provide cemented implants to sufferers present process surgical procedure with arthroplasty. Nevertheless our belief routinely makes use of HAC uncemented stem (Taperloc®, Biomet) hemiarthroplasties. A evaluate of a consecutive sequence of uncemented HAC stem hemiarthroplasties together with measures resembling intro-operative issues, mortality and revision surgical procedure. Prospectively collected knowledge between January 2008 and June 2014 was used, with medical document and radiographic evaluations carried out. 810 consecutive Taperloc uncemented hemiarthroplasty with monopolar heads had been carried out in 763 sufferers, with a minimal 12 month follow-up (12-90) follow-up. Imply age 83yrs; 71% feminine. Meantime to operation was 28.5h. 30day mortality: four.four% (33/763). One 12 months mortality was 11.2% (89/763). 2.5% (20/810) had been admitted on a separate admission with the periprosthetic fracture. zero.6% (5/810) had been revised to whole hip substitute for subsidence and related ache. Just one% (eight/810) had intraoperative calcar fractures, all of which had been handled with intraoperative cabling with no proof of clinically related subsidence or medium time period issues requiring revision surgical procedure inside a 12 months. To the writer’s information that is largest final result sequence for contemporary design uncemented hemiarthroplasty. Our examine exhibits comparable knowledge to cemented hemiarthroplasty however no deaths within the first 2days post-op. Our sequence additionally demonstrates a properly under common mortality figures that are clearly multifactorial however consider uncemented prosthesis play a task. We consider that uncemented confirmed stem design hemiarthroplasty stays a protected and good surgical choice for displaced intracapsular fractures.
PMID: 28259379 [PubMed – indexed for MEDLINE]