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The Influence of Femoral Fixation on Mortality and Revision After Hip Arthroplasty in Femoral Neck Fractures in Patients Older Than 65 Years. A Matched Cohort Analysis From the American Joint Replacement Registry.
J Am Acad Orthop Surg
December 2022
From the OrthoCarolina Hip and Knee Center (Springer), Charlotte, NC, the OrthoCarolina Research Institute (Odum), Charlotte, NC, the American Academy of Orthopaedic Surgeons (De), Rosemont, IL, the University of Arkansas for Medical Sciences (Stambough), Little Rock, AR, the Stanford University (Huddlesto), Woodside, Calif, the University of Wisconsin- School of Medicine and Public Health (UW-SMPH) (Illgen), Madison, WI, and the Orthopaedic Surgery Hospital for Special Surgery (Della Valle), New York, NY.
Introduction: In the United States, most hip arthroplasties for femoral neck fractures are done with a noncemented stem despite worldwide registry data suggesting that cemented fixation has improved long-term survivorship in patients older than 65 years. We, therefore, evaluated the effect of femoral fixation on the risk of revision, revision for periprosthetic fracture (PPFx), and mortality in patients undergoing hip arthroplasty for femoral neck fractures.
Methods: Seventeen thousand one hundred thirty-eight cases of cemented femoral stems were exactly matched to noncemented fixation cases in a 1:1 fashion based on age, sex, and Charlson Comorbidity Index as reported in the American Joint Replacement Registry.