Cemented versus uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly / 中国组织工程研究

ABSTRACT

BACKGROUND:The use of cemented or uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly remains controversial.Therefore,it is necessary to conduct a comparative study on the effectiveness and safety of these two methods.OBJECTIVE:To compare the clinical efficacy of cemented and uncemented hemiarthroplasty for unstable intertrochanteric fractures in the elderly.METHODS:Clinical data of 93 elderly patients with unstable intertrochanteric fractures in Department of Orthopedics,Shandong Energy Zaozhuang Mining Group General Hospital from May 2009 to May 2014 were analyzed retrospectively.All patients were divided into cemented (cemented bipolar hemiarthroplasty for fractures,n=54) and uncemented (uncemented bipolar hemiarthroplasty for fractures,n=39) groups.RESULTS AND CONCLUSION:(1) The amounts of postoperative drainage and blood transfusion in the cemented group were significantly less than those in the uncemented group (P ＜ 0.05),but the operation time was significantly longer (P ＜ 0.05).(2) There were no significant differences in the intraoperative blood loss,ambulation time,hospitalization time,postoperative complications,hip function,and mortality at 3 and 12 months postoperatively between two groups (P ＞ 0.05).(3) Postoperative X-ray showed that all patients had good prosthesis position.There were 10 patients (3 cases in the cemented group,7 cases in the uncemented group) with postoperative prosthesis subsidence,but all of them were less than 3 mm.(4) None of patients had heterotopic ossification,osteolysis around the prosthesis and acetabular cartilage wear during follow-up.Additionally,25 patients (16 cases in the cement group,9 cases in the uncement group) died during follow-up,without prosthesis loosening,and the remaining 68 patients were followed up for 2-7 years,(4.5±2.3) years on average,and none needed revision because of prosthesis loosening.(5) These results indicate that for senile unstable intertrochanteric fractures,both cemented and uncemented hemiarthroplasty can achieve satisfactory curative effectiveness and exhibits good safety.Notably,the cemented prosthesis has advantages in reducing postoperative drainage volume and blood transfusion.