AI Article Synopsis
- The study compared the effects of pressurizing bone cement during hip hemiarthroplasty in patients over 60 with neck of femur fractures, focusing on 30-day post-operative mortality and revision rates for loosening.
- A total of 406 procedures used pressurized cement and 722 used non-pressurized cement, with no significant differences found in mortality rates (7.2% vs. 8.2%) or revision rates for any cause.
- Survival rates at 10 years were slightly better for the pressurized group (15.3%) compared to the non-pressurized group (12.6%), but the overall outcomes were comparable between the two methods.
Article Abstract
Objectives: This study aimed to compare 30-day postoperative mortality, and revision for aseptic femoral component loosening and all-causes after hip hemiarthroplasty, performed with or without pressurization of the bone cement, in patients with neck of femur fracture.
Design: Retrospective cohort study.
Setting: Level I trauma center.
Patient Selection Criteria: Patients ≥60 years with OTA/AO 31B who underwent a cemented hip hemiarthroplasty from December 10, 2007 (database inception) to November 15, 2023 (search date) were reviewed.
Outcome Measures And Comparisons: Comparisons were made between patients who underwent hip hemiarthroplasty with versus without pressurization of the bone cement for outcomes 30-day postoperative mortality, revision for aseptic femoral component loosening, and revision for all-causes.
Results: There were 406 procedures among 402 patients, and 722 procedures among 713 patients that were performed with and without pressurization of the bone cement, respectively. Mean ages were 83.1 and 84.3 years ( P = 0.018), with 72.2% and 68.6% ( P = 0.205) women in the pressurized and non-pressurized cement patient groups, respectively. There were no differences in 30-day postoperative mortality (7.2% vs. 8.2%; HR 0.89, 95% CI 0.46-1.73, P = 0.727). There were no differences in all-cause revision (HR 1.04, 95% CI 0.27-4.04, P = 0.953). No revisions were performed for aseptic loosening. Survival at 10 years postoperatively was 15.3% (95% CI 11.46-19.64) and 12.6% (95% CI 7.67-18.82) among patients who underwent hemiarthroplasty with and without bone cement pressurization, respectively.
Conclusions: There were no differences in 30-day postoperative mortality among patients who underwent hemiarthroplasty with, compared to, without bone cement pressurization. Bone cement pressurization did not confer any advantages for revision outcomes that may be attributed, in part, to patients' high mortality rate and low survival beyond 10 years postoperatively.
Level Of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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| http://dx.doi.org/10.1097/BOT.0000000000002914 | DOI Listing |
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