Extra issues in uncemented in comparison with cemented hemiarthroplasty for displaced femoral neck fractures: a randomized managed trial of 201 sufferers, with one 12 months follow-up.
BMC Musculoskelet Disord. 2017 Apr 21;18(1):169
Authors: Moerman S, Mathijssen NMC, Niesten DD, Riedijk R, Rijnberg WJ, Koëter S, Kremers van de Hei Ok, Tuinebreijer WE, Molenaar TL, Nelissen RGHH, Vochteloo AJH
BACKGROUND: It’s unclear whether or not cemented or uncemented hemiarthroplasty is the perfect therapy choice in aged sufferers with displaced femoral neck fractures. Earlier randomized trials evaluating cemented and uncemented hemiarthroplasty have conflicting outcomes. We carried out a randomized managed trial to check cemented and uncemented hemiarthroplasty.
METHODS: This multicenter parallel-randomized managed trial included sufferers of 70 years and older with a displaced femoral neck fracture (Backyard sort III or IV). Inclusion was between August 2008 and June 2012. Sufferers had been randomized between a cemented hemiarthroplasty, sort Müller Straight Stem or an uncemented hemiarthroplasty, sort DB-10. Main outcomes had been issues, operation time, purposeful end result (measured by Timed-Up-and-Go (TUG) and Groningen Exercise Restriction Scale (GARS)) and mid-thigh ache. Well being Associated High quality of Life (HRQoL, expressed with the SF-12) was measured as an secondary end result. Observe up was 1 12 months.
RESULTS: In complete 201 sufferers had been included within the examine (91 uncemented, 110 cemented hemiarthroplasties) The uncemented group confirmed extra main native issues (intra- and postoperative fractures and dislocations) odds ratio (95% confidence interval) three.36 (1.40 to eight.11). There was no distinction in imply operation time (57.three vs 55.four min). There have been no variations in purposeful outcomes (TUG 12.eight (9.four) vs. 13.9 (9.zero), GARS 43.2 (19.7) vs. 39.2 (16.5)) and mid-thigh ache (18.6 vs 21.6%). Bodily element SF-12 HRQoLwas decrease within the uncemented group (30.three vs. 35.three p?<?zero.05 after six weeks, 33.eight vs 38.5 p?<?zero.05 after 12 weeks).
CONCLUSION: A cemented hemiarthroplasty in aged sufferers with a displaced femoral neck fracture leads to much less issues in comparison with an uncemented hemiarthroplasty.
TRIAL REGISTRATION: Netherlands Trial Registry; NTR 1508 , accepted date 27 okt 2008.
PMID: 28431543 [PubMed – indexed for MEDLINE]