DOS 2016

DOS Kongressen 2016 ·

Reoperations after cemented and uncemented

hemiarthroplasty - A study from the Danish

Multidisciplinary Registry of Hip Fractures (DMRHF)

Bjarke Viberg, Alma Becic Pedersen, Anders Kjærsgaard, Jens Lauritsen, Søren

Overgaard

Department of Orthopaedic Surgery and Traumatology, Odense University

Hospital; Department of Clinical Epidemiology, Aarhus University Hospital;

Department of Clinical Epidemiology, Aarhus University Hospital; Department

of Orthopaedic Surgery and Traumatology, Odense University Hospital;

Department of Orthopaedic Surgery and Traumatology, Odense University

Hospital

Background:

Cemented hemiarthroplasty (cemHA) has in several nationwide

registries shown to be superior to uncemented hemiarthroplasty (uncemHA) in

regards to reoperation, but still the uncemented is used in a number of countries.

Purpose / Aim of Study:

To compare the reoperations for cemHA vs uncemHA

in hip fracture patients with up to 5 years’ follow-up.

Materials and Methods:

This is a population based register study with data

from DMRHF and the Danish National Registry of Patients. Data was retrieved

from 01.01.2004 to 12.31.2013 with a minimum of 2 years’ follow-up on pro-

cedure codes (NFB02, NFB12), age, sex, Charlson Comorbidity Index (CCI), re-

operation status and vital status. Among 70,652 hip fractures in total, 16.741

have had a HA. Reoperation was defined as dislocations, periprostethic fractures,

deep infections and other reasons, and were based on data reported to DNRP.

Findings / Results:

There were 8513 uncemHA and 8228 cemHA with no

difference between median age (quartiles) of 84.2 (79.1-88.7) for uncemHA

and 83.8 (78.5-88.5) for cemHA, respectively. There were 76 % females in

both groups and the median follow-up was 3.5 years. The reoperation percent-

age was 4.6 % for uncemHA and 3.4 % for cemHA. A crude Cox-regression

analysis using Hazard Ratio (HR) with 95 % CI for uncemHA compared to cemHA

yielded 0.72 (0.62;0.84) after 1 year, 0.76 (0.63;0.91) from 1-2 years, and

0.68 (0.56;0.82) from 2-5 years. When adjusting for age, sex, and CCI the HR

was 0.72 (0.62;0.84) after 1 year, 0.75 (0.63:0.90) from 1-2 years, and 0.68

(0.56;0.82) from 2-5 years. Higher age seems to be a protective factor.

Conclusions:

CemHA has an overall lower reoperation percentage compared to

ucemHA and this nationwide study from DK suggest that patients with femoral

neck fractures should be treated with a cemHA rather than a uncemHA.

No conflicts of interest reported

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