Displaced intracapsular neck of femur fractures: Outcome of 810 hydroxyapetite coated (HAC) uncemented hemiarthroplasties |
| |
| Affiliation: | 1. University of Edinburgh, United Kingdom;2. Department of Trauma & Orthopaedics, Edinburgh Royal Infirmary, United Kingdom;3. Royal Infirmary of Edinburgh, United Kingdom;1. Department of Surgery, Division of Trauma, Critical Care, and General Surgery, Mayo Clinic, Rochester, MN, United States;2. Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, United States;3. Office of Translation to Practice, Mayo Clinic, Rochester, MN, United States;4. Mayo Medical School, Mayo Clinic, Rochester, MN, United States;5. Department of Surgery, University of Minnesota, Minneapolis, MN, United States;1. Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan;2. Department of Orthopaedics, Srinakharinwirot University, Nakhon Nayok, Thailand;3. Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan;4. Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan;1. Third Hospital of Hebei Medical University, Department of Orthopaedic Surgery, Shijiazhuang, Hebei, 050051, China;2. Hebei Medical University, Shijiazhuang, Hebei, 050051, China;1. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China;2. Department of Traumatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, China |
| |
| Abstract: | A Cochrane review influenced new NICE guidelines, which recommended surgeons: Offer cemented implants to patients undergoing surgery with arthroplasty. However our trust routinely uses HAC uncemented stem (Taperloc®, Biomet) hemiarthroplasties. A review of a consecutive series of uncemented HAC stem hemiarthroplasties including measures such as intro-operative complications, mortality and revision surgery.Prospectively collected data between January 2008 and June 2014 was used, with medical record and radiographic reviews performed.810 consecutive Taperloc uncemented hemiarthroplasty with monopolar heads were performed in 763 patients, with a minimum 12 month follow-up (12–90) follow-up. Mean age 83 yrs; 71% female. Meantime to operation was 28.5 h. 30 day mortality: 4.4% (33/763). One year mortality was 11.2% (89/763). 2.5% (20/810) were admitted on a separate admission with the periprosthetic fracture. 0.6% (5/810) were revised to total hip replacement for subsidence and associated pain. Only 1% (8/810) had intraoperative calcar fractures, all of which were treated with intraoperative cabling with no evidence of clinically relevant subsidence or medium term complications requiring revision surgery within a year.To the author’s knowledge this is largest outcome series for modern design uncemented hemiarthroplasty. Our study shows comparable data to cemented hemiarthroplasty but no deaths in the first 2 days post-op. Our series also demonstrates a well below average mortality figures which are clearly multifactorial but believe uncemented prosthesis play a role. We believe that uncemented proven stem design hemiarthroplasty remains a safe and good surgical option for displaced intracapsular fractures. |
| |
| Keywords: | Neck of femur fracture Intracapsular Hemiarthroplasty Uncemented |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
