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Fixation Methods in Primary Hip Arthroplasty: A Nationwide, Registry-Based Observational Study in Romania (2001-2024)
Flaviu Moldovan1, Liviu Moldovan2
1Orthopedics-Traumatology Department, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Background/Objectives:
Arthroplasty registries provide a broad database that constitutes evidence for discussions about cemented versus uncemented fixations. The objective of this study is to determine the current trend in fixation of total hip arthroplasties.
Methods:
From the Romanian Arthroplasty Register we extracted data regarding primary hip replacement surgery and revisions. We established evaluation variables and methodologies that contain volumes, variation trends, and gradients for surgical procedures, fixations and revision burdens.
Results:
In the period 2001-2024, the share of uncemented fixations was 56.8%, and that of cemented ones was 43.13%. The uncemented fixation gradient showed an increase from 0.32 in 2001 to 3.43 in 2024. We found an annual increase in the share of uncemented fixations (2.08%), to the detriment of cemented fixations, which decreased (-6.97%). We found that there is an obvious trend towards uncemented fixation, which is also evident in the elderly age group of 80+ years. The results regarding revision burdens remain within a relatively narrow range of 5.09-7.23%. The revision burdens of uncemented fixations are lower, ranging between 4.82% and 5.36%, compared to cemented fixations. Also, the revision burdens of cemented fixations have a decreasing trend of 0.54%.
Conclusions:
The variation trend of total uncemented implants is almost double compared to the variation trend of all primary hip joint surgeries. This indicates a trend towards uncemented fixation, and its share is increasing in all age groups. The increase in the proportion of uncemented fixations was associated with a small, non-significant decrease in revision burden.
