Document Type : RESEARCH PAPER
Authors
1
Boston VA Medical Center, Boston, MA, USA
2
Orthopedic Resident, Boston Medical Center, Boston University, Boston, MA, USA
3
Paul L. Foster School of Medicine, Texas Tech Health Sciences Center,El Paso, Texas, USA
4
University of Texas Southwestern, Dallas, Texas, USA
5
Dallas VA medical center, Dallas, USA
Abstract
Objectives: This study aimed to analyze and compare the perioperative outcomes of cemented and
uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures by utilizing the
data from the National Inpatient Sample database.
Methods: Data from the National Inpatient Sample Database was analyzed to identify patients who underwent
hemiarthroplasty following a displaced femoral neck fracture (cemented and uncemented. Demographic data,
comorbidities, length of stay, total charges, and perioperative complications were analyzed.
Results: 27390 patients were identified in the cemented group and 29406 in the uncemented group. The patients
who underwent uncemented hemiarthroplasty demonstrated a higher incidence of prosthetic dislocation (Odds Ratio
(OR) 3.348, p < 0.001), periprosthetic mechanical complications (OR 2.597, p < 0.001), wound dehiscence (OR
2.883, p < 0.001), superficial surgical site infection (OR 2.396, p = 0.043), deep surgical site infection (OR 1.686, p
< 0.001), and periprosthetic fractures (OR 2.292, p < 0.001) as compared with patients who underwent cemented
hemiarthroplasty. However, patients with uncemented fixation demonstrated a lower incidence of death (OR 0.567,
p < 0.001), pulmonary embolism (OR 0.565, p < 0.001), deep vein thrombosis (DVT) (OR 0.746, p < 0.001),
myocardial infarction (OR 0.772, p = 0.025) and blood loss anemia (OR 0.869, p < 0.001) as compared with
cemented fixation.
Conclusion: Our study on displaced femoral neck fractures utilizing the National Inpatient database found that
uncemented hemiarthroplasty was associated with a higher incidence of perioperative surgical complications.
Cemented hemiarthroplasty, however, was associated with a statistically significant higher rate of death, pulmonary
embolism, deep vein thrombosis, and myocardial infarction.
Level of evidence: III
Keywords
Main Subjects