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National guidelines recommend cemented hemiarthroplasty for intracapsular fractured neck of femur (NOF), based on evidence of less pain, better mobility and lower costs. We aimed to compare complications following cemented and cementless implants, using the national hospital episode statistics (HES) database in England. Dislocation, revision, return to theatre and medical complications were extracted for all patients with NOF fracture who underwent hemiarthroplasty between January 2005 and December 2008. To make a 'like for like' comparison all 30,424 patients with a cementless implant were matched to 30,424 cemented implants (from a total of 42,838) in terms of age, sex and Charlson co-morbidity score. In the cementless group, 18-month revision (1.62% versus 0.57% (OR 2.90, p<0.001)), 4-year revision (2.45% versus 1.11% (OR 2.28, p<0.001)) and 30-day chest infection (8.14% versus 7.23% (OR 1.14, p=0.028)) were significantly higher. Four-year dislocation rate was higher in cemented implants (0.60% versus 0.26% (OR 0.45, p<0.001)). No significant differences were seen in return to theatre or other medical complications. In this national analysis of matched patients mid-term revision and perioperative chest infection was significantly higher in the cementless group. This supports the published evidence and national guidelines recommending cement fixation of hemiarthroplasty.

Original publication

DOI

10.1016/j.injury.2012.10.031

Type

Journal article

Journal

Injury

Publication Date

06/2013

Volume

44

Pages

730 - 734

Addresses

National Orthopaedic Research and Surgical Outcomes, Newcastle, UK; Northern Deanery Trauma & Orthopaedic Training Scheme, Waterfront 4, Goldcrest Way, Newcastle, UK.

Keywords

Humans, Pain, Hip Dislocation, Femoral Neck Fractures, Bone Cements, Treatment Outcome, Reoperation, Registries, Survival Rate, Odds Ratio, Aged, Aged, 80 and over, Middle Aged, Cost-Benefit Analysis, Female, Male, Practice Guidelines as Topic, Hemiarthroplasty, United Kingdom