A Comparative Study on the Outcome of Cemented and Cementless Stems during Total Hip Arthroplasty Conversion in Patients with Failed Osteosynthesis of Proximal Femur Fracture.

William K Crockatt, Mouhanad M El Othmani, Marcel M Dupont, Jude T Okonkwo, Nana O Sarpong, Carl L Herndon
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Abstract

Purpose: Cementless femoral fixation has become widely adopted throughout the United States for primary total hip arthroplasty (THA). However, femoral fixation in conversion THA (convTHA) presents unique challenges, and optimal strategies have not been extensively studied. This study investigated differences in outcomes for cemented versus cementless femoral fixation in convTHA for patients with failed osteosynthesis after proximal femur fracture.

Materials and methods: Data was retrospectively collected for 75 patients who underwent convTHA after previous proximal femur fracture. Based on type of femoral fixation type at time of conversion, patients were sorted into two cohorts, cemented (n=19) or cementless (n=56). Demographic, surgical, and outcome variables, including revision and complication rates, were collected and compared between the cemented and cementless cohorts. Statistical analyses were performed using multivariate regression analyses.

Results: As compared to the cemented cohort, patients for whom cementless implants were chosen tended to be younger (P<0.01), male (P=0.03), and non-white (P<0.01). The cementless cohort had shorter surgical time (149.64 minutes vs. 197.16 minutes, P=0.01). No differences were noted in anesthesia type (P=0.93), surgical approach (P=0.84), or use of dual mobility implants (P=0.93). Multivariable logistic regression analysis revealed that there was no difference in length of stay (LOS), revision rate, complication rate, or discharge disposition between the cemented and cementless cohorts.

Conclusion: Our results revealed shorter operative times with cementless femoral fixation in convTHA, but no significant difference in LOS, discharge disposition, revision rate, or complication rate when compared with cemented fixation.

股骨近端骨折成骨失败患者全髋关节置换术中骨水泥与无骨水泥假体的对比研究。
目的:在美国,无水泥股骨固定已被广泛应用于初次全髋关节置换术(THA)。然而,在转换THA (convTHA)中,股骨固定具有独特的挑战,最佳策略尚未得到广泛研究。本研究探讨了股骨近端骨折后骨融合术失败的患者,采用骨水泥与无骨水泥进行反向tha固定的疗效差异。材料和方法:回顾性收集75例股骨近端骨折后行椎体置换手术的患者资料。根据转换时股骨固定类型,将患者分为两组,有骨水泥组(n=19)和无骨水泥组(n=56)。收集人口统计学、手术和结局变量,包括翻修和并发症发生率,并在骨水泥组和非骨水泥组之间进行比较。采用多元回归分析进行统计分析。结果:与骨水泥组相比,选择无骨水泥种植体的患者往往更年轻(PP=0.03),非白人(PP=0.01)。麻醉类型(P=0.93)、手术入路(P=0.84)或双活动植入物的使用(P=0.93)均无差异。多变量logistic回归分析显示,骨水泥组和非骨水泥组在住院时间(LOS)、翻修率、并发症发生率或出院处置方面没有差异。结论:我们的研究结果显示,与骨水泥固定相比,非骨水泥股骨内固定在convTHA中缩短了手术时间,但在LOS、出院处置、翻修率或并发症发生率方面没有显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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