Cemented versus Cementless Total Hip Arthroplasty for Femoral Head Osteonecrosis: A Study Based on National Claim Data in South Korea.

J Am Acad Orthop Surg Glob Res Rev

From the Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea (Dr. J-W. Park, Dr. Ko, Dr. Lee, and Dr. Koo); the Data Science Team, Hanmi Pharm. Co., Ltd, Seoul, Korea (Ms. S. Park); the Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea (Mr. Kim); the Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, South Korea (Dr. Lee); and the Department of Orthopaedic Surgery, Kay Joint Center, Cheil Orthopaedic Hospital, Seoul, South Korea (Dr. Koo).

Published: May 2023

Introduction: The purpose of this study was to compare the rates of revision, periprosthetic joint infection (PJI), and periprosthetic fracture (PPF) between patients with osteonecrosis of the femoral head (ONFH) undergoing noncemented total hip arthroplasty (THA) and cemented THA using a national claim data in South Korea.

Methods: We identified patients who received THA for ONFH from January 2007 to December 2018 using ICD diagnosis codes and procedural codes. Patients were categorized into two groups according to the fixation method: with or without cement. The survivorship of THA was calculated using the following end points: revision of both the cup and stem, revision of the single component, any type of revision, PJI, and PPF.

Results: A total of 40,606 patients: 3,738 patients (9.2%) with cement and 36,868 patients (90.7%) without cement, received THA for ONFH. The mean age of the noncemented fixation group (56.2 ± 13.2 years) was significantly lower than that of the cemented fixation group (57.0 ± 15.7 years, P = 0.003). The risk of revision and PJI was notably higher in cemented THA (hazard ratio: 1.44 [1.21 to 1.72] and 1.66 [1.36 to 2.04], respectively). Noncemented THA had a higher 12-year survivorship compared with cemented THA with any revision and PJI as the end point.

Discussion: Noncemented fixation had better survivorship than cemented fixation in patients with ONFH.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155893PMC
http://dx.doi.org/10.5435/JAAOSGlobal-D-23-00029DOI Listing

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