Uncemented versus cemented total hip arthroplasty for displaced femoral neck fractures in elderly patients with osteoporosis: A retrospective analysis

J Int Med Res. 2020 Aug;48(8):300060520944663. doi: 10.1177/0300060520944663.

Abstract

Objective: This study was performed assess the clinical outcomes of elderly patients with osteoporotic femoral neck fractures (FNFs) (AO/OTA: 31B/C) treated by initial uncemented total hip arthroplasty (UTA) or cemented total hip arthroplasty (CTA).

Methods: This study involved consecutive elderly patients with osteoporotic FNFs (AO/OTA: 31B/C) treated by initial UTA or CTA in our medical centre from 2010 to 2015. The primary outcomes were the Harris hip score (HHS) and the rates of revision, loosening, periprosthetic fracture, and dislocation.

Results: In total, 224 patients were included in the final analysis (UTA, n = 114; CTA, n = 110). The mean follow-up duration was 60 months (range, 32-68 months). The mean HHS was 75.34 ± 18.82 for UTA and 80.12 ± 17.83 for CTA. Significant dissimilarities were detected in the rates of revision, loosening, and periprosthetic fracture between UTA and CTA (14.0% vs. 5.5%, 20.2% vs. 10.0%, and 12.3% vs. 4.5%, respectively). A significant difference was also detected in the probability of revision between the two groups.

Conclusion: Elderly patients with osteoporotic FNFs (AO/OTA: 31B/C) treated with CTA show greater improvements in functional outcomes and key orthopaedic complications than those treated with UTA.

Keywords: Femoral neck fracture; arthroplasty; complication; osteoporosis; outcome; retrospective.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Hip*
  • Femoral Neck Fractures* / diagnostic imaging
  • Femoral Neck Fractures* / surgery
  • Hip Prosthesis*
  • Humans
  • Osteoporosis* / complications
  • Osteoporosis* / surgery
  • Retrospective Studies
  • Treatment Outcome