Background: A discussion is ongoing whether displaced femoral neck fractures in elderly patients should be treated with a non-cemented or a cemented hemiarthroplasty. A recent Cochrane analysis stresses the importance of further research into the relative merits of these techniques. We hypothesise that non-cemented hemiarthroplasty will result in at least the same technical-functional outcome and complication rate, with a shorter operation time.
Methods And Design: A randomised controlled multicentre trial will be performed.The study population consists of 200 patients of 70 years and older. Patients with a displaced femoral neck fracture will be allocated randomly to have a cemented or a non-cemented hemiarthroplasty. Data will be collected preoperatively, immediately postoperatively, and 6 weeks, 3 months and 1 year postoperatively.The main outcome measures of this study are technical-functional results of the hemiarthroplasty, duration of surgery, complications, and mid-thigh pain. Secondary outcome measures are living conditions at final follow up, self-reported health-related quality of life, and radiological evaluation of the hemiarthroplasty.
Conclusion: A recent Cochrane analysis did not find arguments in favour of either non-cemented or cemented hemiarthroplasty. The forthcoming trial will compare treatment for a displaced femoral neck fracture by cemented versus non-cemented hemiarthroplasty. Our results will be published as soon as they become available.
Trial Registration: Trial Registration Number NTR1508.
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http://dx.doi.org/10.1186/1471-2474-10-56 | DOI Listing |
Pak J Med Sci
July 2024
Dr. Mian Asad Ullah, MBBS. Department of Trauma & Orthopedics, Lady Reading Hospital, Peshawar, Pakistan.
Objective: To know about the trends in the management of neck of femur fractures with arthroplasty in patients ≥ 50 years.
Methods: It is a retrospective cross-sectional study with data collection from Hospital Management Information System from 1 January 2020 to 31 July 2023. SPSS version 25 was used for data analysis.
Eur J Orthop Surg Traumatol
May 2024
Division of Orthopedic Trauma Surgery, Department of Orthopedic Surgery, NYU School of Medicine, NYU Langone Health, NYU Langone Orthopedic Hospital, 301 East 17th Street, 14th Floor, New York, NY, 10003, USA.
Background: Periprosthetic femoral fractures (PFF) carry significant morbidity following arthroplasty for femoral neck fracture (FNF). This study assessed fracture complications following arthroplasty for FNF and the effect of cement fixation of the femoral component on intraoperative and post-operative PFF.
Methods: Between February 2014 and September 2021, 740 patients with a FNF who underwent arthroplasty were analyzed for demographics, surgical management, use of cement for fixation of the femoral component, and subsequent PFF.
Sci Rep
October 2023
Institute of Movement and Locomotion, Aix-Marseille Université et CNRS 5, Marseille, France.
Mortality related to femoral neck fractures remains a challenging health issue, with a high mortality rate at 1 year of follow-up. Three modifiable factors appear to be under control of the surgeon: the choice of the implant, the use of cement and the timing before surgery. The aim of this research project was to study the impact on mortality each of these risk factors play during the management of femoral neck fractures.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
June 2022
Department of Orthopaedic, Trauma and Plastic Surgery, University Hospital of Leipzig, Liebigstr. 20, 04105, Leipzig, Germany.
Purpose: Hemiarthroplasty is widely accepted as the treatment of choice in elderly patients with a displaced intracapsular femoral neck fracture. Intraoperative greater trochanteric fractures thwart this successful procedure, resulting in prolonged recovery, inferior outcome, and increased risk of revision surgery. Hence, this study analyzed factors potentially associated with an increased risk for intraoperative greater trochanteric fracture.
View Article and Find Full Text PDFBMC Musculoskelet Disord
December 2019
Institute of Health and Welfare Policy, College of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 11221, Taiwan, Republic of China.
Background: Hip hemiarthroplasty (HHA) is a common treatment for hip fractures in the elderly population. Because of the fatal effects of bone cement implantation syndrome, the safety of cement utilization to enhance implant firmness in the femur is controversial. The aim of this study was to investigate the postoperative survival of elderly patients receiving HHA with and without cement fixation.
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