Higher rate of complications with uncemented compared to cemented total hip arthroplasty for displaced intracapsular hip fractures: A randomised controlled trial of 50 patients
| Autor: | Marietta L. van der Linden, Nicholas D. Clement, John F. Keating |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Arthroplasty Replacement Hip Oxford hip score law.invention 03 medical and health sciences 0302 clinical medicine Patient satisfaction Randomized controlled trial Blood loss Double-Blind Method law Uncement medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Prospective Studies Function Outcome 030222 orthopedics Hip fracture business.industry Hip Fractures Bone Cements medicine.disease Surgery Log-rank test Cemented surgical procedures operative Treatment Outcome Harris Hip Score Original Article Total hip arthroplasty Hip Prosthesis business |
| Zdroj: | European Journal of Orthopaedic Surgery & Traumatology |
| ISSN: | 1432-1068 1633-8065 |
| Popis: | Background The primary aim of this study was to compare the functional outcome of uncemented with cemented total hip arthroplasty (THA) for displaced intracapsular hip fractures. The secondary aims were to assess length of surgery, blood loss, complications and revision rate between the two groups. Methods A prospective double-blind randomised control trial was conducted. Fifty patients with an intracapsular hip fracture meeting the inclusion criteria were randomised to either an uncemented (n = 25) or cemented (n = 25) THA. There were no differences (p > 0.45) in age, gender, health status or preinjury hip function between the groups. The Oxford hip score (OHS), Harris Hip score (HHS), EuroQol 5-dimensional (EQ5D), timed get up-and-go (TUG), pain and patient satisfaction were used to assess outcome. These were assessed at 4, 12 and 72 months after surgery, apart from the TUG which as only assessed as 6 months. Results The study was terminated early due to the significantly (n = 8, p = 0.004) higher rate of intraoperative complications in the uncemented group: three fractures of the proximal femur and five conversions to a cemented acetabular component. There were no significant (p ≥ 0.09) differences in the functional measures (OHS, HSS, EQ5D, TUG and pain) or patient satisfaction between the groups. There was no difference in operative time (p = 0.75) or blood loss (p = 0.66) between the groups. There were two early revisions prior to 3 months post-operatively in the uncemented group and none in the cemented group, but this was not significant (log rank p = 0.16). Conclusion There was a high rate of intraoperative complications, which may be due to poor bone quality in this patient group. There were no ergonomic or functional advantages demonstrated between uncemented and cemented THA. Cemented THA should remain as the preferred choice for the treatment of intracapsular hip fractures for patients that meet the criteria for this procedure. |
| Databáze: | OpenAIRE |
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