Cement Use in Bipolar Hemiarthroplasty and Its Association With Cancer Risk

Area of Science:

• Orthopedic Surgery
• Oncology
• Epidemiology

Background:

• Previous studies lacked differentiation between cemented and cementless fixation in assessing polymethylmethacrylate (PMMA) use and cancer risk in hemiarthroplasty (HA).
• This study addresses the need to clarify cancer incidence differences between cemented and cementless HA.
• The trial is registered under NCT06307145.

Purpose of the Study:

• To compare the incidence of cancer in patients undergoing cemented versus cementless HA.
• To investigate the specific cancer risks associated with different HA fixation techniques.

Main Methods:

• A retrospective nationwide cohort study utilized the Korean National Health Insurance Service database (N = 160,394).
• Adult patients undergoing HA between 2003-2019 were analyzed, excluding those with prior surgeries, bilateral procedures, or cancer history.
• Cancer incidence was assessed using insurance and diagnosis codes, with Kaplan-Meier curves and Cox models comparing cemented and cementless groups.

Main Results:

• No significant differences in overall cancer, solid tumor, or hematologic cancer risk were found between cemented and cementless HA groups.
• The cemented HA group showed a 1.8-fold increased risk of multiple myeloma compared to the cementless group.
• This association was more pronounced in patients under 70 years old (adjusted hazard ratio, 3.44).

Conclusions:

• Cemented HA is associated with an elevated risk of multiple myeloma compared to cementless HA.
• The risk of multiple myeloma linked to cement use in HA is particularly significant in younger patient populations.
• Findings emphasize evaluating long-term risks of cemented HA to guide safer surgical practices and treatment choices.