Alexandra Rocha, Lyndsay Somerville, Patrick Moody, Brent A Lanting, James L Howard, Doug D R Naudie, Richard W McCalden, Steven J MacDonald, Edward M Vasarhelyi
{"title":"Cementless Versus Cemented Stems in Patients Aged 70 Years or Older Undergoing Total Hip Arthroplasty.","authors":"Alexandra Rocha, Lyndsay Somerville, Patrick Moody, Brent A Lanting, James L Howard, Doug D R Naudie, Richard W McCalden, Steven J MacDonald, Edward M Vasarhelyi","doi":"10.1016/j.arth.2025.02.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Controversy continues to exist regarding the most appropriate femoral implant selection in older patients undergoing total hip arthroplasty (THA). Our study aimed to compare the survivorship, reasons for revision, and patient-reported outcome measures (PROMs) of uncemented versus cemented THA in patients aged ≥ 70 years.</p><p><strong>Methods: </strong>This retrospective study reviewed primary THAs performed on patients aged ≥ 70 years between January 1, 2007, and October 1, 2019. A total of 2,136 patients [cemented (n = 355), cementless (n = 1,781)] were included. Demographics including age (77 versus 83), Body Mass Index (BMI) (29 versus 26), and sex (59 versus 83% women) were different between the cementless and cemented THA cohorts, respectively. Patient characteristics, implant characteristics, revision information, mortality, and PROMs [Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Veterans Rand 12 Item Health Survey (VR12), and the Harris Hip Score (HHS)] were collected. Kaplan-Meier survivorship was performed with all-cause, aseptic, and aseptic stem revisions as the endpoint. Change scores were calculated and compared with independent t-tests.</p><p><strong>Results: </strong>There were no differences in the 5- and 10-year cumulative survival in the cementless and cemented THA cohorts for all-cause (P = 0.11), aseptic (P = 0.83), and aseptic stem revisions (P = 0.61). Both cohorts demonstrated excellent long-term survival for all-cause (96.8 versus 95.5), aseptic (97.8 versus 98.3), and aseptic stem (98.4 versus 98.3) revisions. There were no differences in change scores for WOMAC (33.9 versus 35.3, P = 0.48), VR12 Mental (0.56 versus 1.42, P = 0.58), VR12 Physical (8.9 versus 8.0, P = 0.21), and HHS (43.1 versus 44.9, P = 0.25) scores between the cementless and cemented cohorts at the latest follow-up.</p><p><strong>Conclusion: </strong>No difference was found in survival rates of cementless compared to cemented stems for all causes and aseptic causes in patients aged ≥ 70 years undergoing elective THA. Both cementless and cemented femoral stems provide a safe and efficacious option for performing THA in older patients.</p>","PeriodicalId":51077,"journal":{"name":"Journal of Arthroplasty","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arthroplasty","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arth.2025.02.008","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Controversy continues to exist regarding the most appropriate femoral implant selection in older patients undergoing total hip arthroplasty (THA). Our study aimed to compare the survivorship, reasons for revision, and patient-reported outcome measures (PROMs) of uncemented versus cemented THA in patients aged ≥ 70 years.
Methods: This retrospective study reviewed primary THAs performed on patients aged ≥ 70 years between January 1, 2007, and October 1, 2019. A total of 2,136 patients [cemented (n = 355), cementless (n = 1,781)] were included. Demographics including age (77 versus 83), Body Mass Index (BMI) (29 versus 26), and sex (59 versus 83% women) were different between the cementless and cemented THA cohorts, respectively. Patient characteristics, implant characteristics, revision information, mortality, and PROMs [Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Veterans Rand 12 Item Health Survey (VR12), and the Harris Hip Score (HHS)] were collected. Kaplan-Meier survivorship was performed with all-cause, aseptic, and aseptic stem revisions as the endpoint. Change scores were calculated and compared with independent t-tests.
Results: There were no differences in the 5- and 10-year cumulative survival in the cementless and cemented THA cohorts for all-cause (P = 0.11), aseptic (P = 0.83), and aseptic stem revisions (P = 0.61). Both cohorts demonstrated excellent long-term survival for all-cause (96.8 versus 95.5), aseptic (97.8 versus 98.3), and aseptic stem (98.4 versus 98.3) revisions. There were no differences in change scores for WOMAC (33.9 versus 35.3, P = 0.48), VR12 Mental (0.56 versus 1.42, P = 0.58), VR12 Physical (8.9 versus 8.0, P = 0.21), and HHS (43.1 versus 44.9, P = 0.25) scores between the cementless and cemented cohorts at the latest follow-up.
Conclusion: No difference was found in survival rates of cementless compared to cemented stems for all causes and aseptic causes in patients aged ≥ 70 years undergoing elective THA. Both cementless and cemented femoral stems provide a safe and efficacious option for performing THA in older patients.
期刊介绍：
The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
