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Comparing Outcomes in Cemented and Press-Fit Hemiarthroplasty
Jordan Brand1, Lidia Ani, Kelsey A Rankin
1From the Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
Summary
Cemented hemiarthroplasty for geriatric femoral neck fractures is associated with fewer revision surgeries compared to press-fit. While press-fit showed longer survival trends, cemented fixation may offer better outcomes for this patient group.
Area of Science:
- Orthopedic surgery
- Geriatric trauma care
Background:
- Arthroplasty is standard for geriatric femoral neck fractures.
- Optimal implant design and fixation remain debated.
Purpose of the Study:
- Compare cemented vs. press-fit hemiarthroplasty outcomes.
- Evaluate revision surgery, contralateral fractures, hospital stay, mortality, and survival.
Main Methods:
- Retrospective review of 707 geriatric hip fractures (2014-2019).
- Compared cemented (309) vs. press-fit (398) hemiarthroplasty.
- Statistical analysis included Z-score test, t-test, and Cox proportional hazard models.
Main Results:
- Press-fit had higher revision rates (7.8% vs 3.9%, P=0.006).
- No significant differences in contralateral fractures, length of stay, or mortality.
- Press-fit showed a trend towards longer survival (413 vs 615 days, P<0.001).
Conclusions:
- Press-fit hemiarthroplasty linked to higher revision rates.
- Cemented hemiarthroplasty may be more beneficial for displaced geriatric femoral neck fractures.
- Surgeon bias towards cementing in sicker patients may influence survival data.
