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Cementless Hemiarthroplasty Complication Risk Does Not Support Contemporary Utilization Patterns.

Robert A Burnett1, Anne J Hakim1, Brenna E Blackburn1

  • 1Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah.

The Journal of Arthroplasty
|April 5, 2025
PubMed
Summary
This summary is machine-generated.

Cementless hemiarthroplasty (HA) for femoral neck fractures shows higher complication rates, including an 11-fold increased risk of periprosthetic fracture compared to cemented HA. Cemented fixation may reduce revision surgery needs.

Keywords:
cementless hemiarthroplastycomplicationsfemoral neck fracturehemiarthroplastyperiprosthetic joint infection

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Hemiarthroplasty (HA) is a common procedure for femoral neck fractures, enabling early patient mobilization.
  • Femoral component fixation in HA can be achieved through press-fit (cementless) or cemented methods.
  • This study compares the utilization and complication profiles of cemented versus cementless HA.

Purpose of the Study:

  • To compare the incidence of revision surgery due to periprosthetic fracture between cemented and cementless HA.
  • To evaluate secondary outcomes including operative time, surgical complications, and mortality.
  • To analyze the risk factors associated with complications in HA for femoral neck fractures.

Main Methods:

  • A multicenter retrospective analysis of hip fracture patients from 2010 to 2019.
  • Primary outcome: revision for periprosthetic fracture.
  • Logistic regression analysis adjusted for patient demographics and comorbidities.

Main Results:

  • Cementless HA was more frequently utilized (58.6%) than cemented HA (41.4%).
  • Cementless HA was associated with higher rates of revision for periprosthetic fracture (2.6% vs 0.3%) and dislocation (6.1% vs 2.7%).
  • Cementless HA patients had shorter operative times but were less likely to return to independent ambulation.

Conclusions:

  • Cementless HA presents a significantly higher risk of surgical complications, notably periprosthetic fractures, compared to cemented HA.
  • The findings suggest that cemented fixation may be preferable for HA in femoral neck fractures to minimize revision surgery.
  • Consideration of cemented fixation is recommended to mitigate risks associated with cementless HA.