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Cemented or cementless THA in patients over 80 years with fracture neck of femur: a prospective comparative trial

Background Total hip arthroplasty is associated with a better long term outcome and lesser reoperation rates in the elderly but the risk of complications are beleived to be higher in very elderly patients. The study aims to compare the short-term results of cemented and cementless total hip arthropl...

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Published in:Musculoskeletal surgery 2014-12, Vol.98 (3), p.205-208
Main Authors: Gavaskar, A. S., Tummala, N. C., Subramanian, M.
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Tummala, N. C.
Subramanian, M.
description Background Total hip arthroplasty is associated with a better long term outcome and lesser reoperation rates in the elderly but the risk of complications are beleived to be higher in very elderly patients. The study aims to compare the short-term results of cemented and cementless total hip arthroplasty (THA) in active patients >80 years of age with femoral neck fractures. Methods Sixty-two consecutive patients underwent THA during the study period (cemented—31 and cementless—31). The mean age was 84 years (81–94 years). Patients in both groups were comparable in their preoperative variables. Functional and radiological assessments were carried out using validated outcome measures. Complications were recorded. Results Fifty-one patients were available for final analysis after accounting for deaths and cases lost in follow-up. Of the 51 patients, 25 (49 %) regained their pre-injury mobility status and 36 (70 %) were community ambulant. Cementless THA was associated with significantly less surgical time, blood loss, transfusion rates and hospital stay. The overall mortality rates, complications, functional and radiological results were similar in both groups though the number of deaths in the perioperative period was significantly high in patients undergoing cemented THA. Conclusion Satisfactory improvement in function with low reoperation rates can be achieved irrespective of the technique used. Complication rates are higher when compared to younger patients undergoing the procedure. Risks and benefits should be carefully assessed and explained before subjecting these patients to THA.
doi_str_mv 10.1007/s12306-013-0296-6
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S. ; Tummala, N. C. ; Subramanian, M.</creator><creatorcontrib>Gavaskar, A. S. ; Tummala, N. C. ; Subramanian, M.</creatorcontrib><description>Background Total hip arthroplasty is associated with a better long term outcome and lesser reoperation rates in the elderly but the risk of complications are beleived to be higher in very elderly patients. The study aims to compare the short-term results of cemented and cementless total hip arthroplasty (THA) in active patients &gt;80 years of age with femoral neck fractures. Methods Sixty-two consecutive patients underwent THA during the study period (cemented—31 and cementless—31). The mean age was 84 years (81–94 years). Patients in both groups were comparable in their preoperative variables. Functional and radiological assessments were carried out using validated outcome measures. Complications were recorded. Results Fifty-one patients were available for final analysis after accounting for deaths and cases lost in follow-up. Of the 51 patients, 25 (49 %) regained their pre-injury mobility status and 36 (70 %) were community ambulant. Cementless THA was associated with significantly less surgical time, blood loss, transfusion rates and hospital stay. The overall mortality rates, complications, functional and radiological results were similar in both groups though the number of deaths in the perioperative period was significantly high in patients undergoing cemented THA. Conclusion Satisfactory improvement in function with low reoperation rates can be achieved irrespective of the technique used. Complication rates are higher when compared to younger patients undergoing the procedure. Risks and benefits should be carefully assessed and explained before subjecting these patients to THA.</description><identifier>ISSN: 2035-5106</identifier><identifier>EISSN: 2035-5114</identifier><identifier>DOI: 10.1007/s12306-013-0296-6</identifier><identifier>PMID: 23912215</identifier><language>eng</language><publisher>Milan: Springer Milan</publisher><subject>Aged, 80 and over ; Arthroplasty, Replacement, Hip - methods ; Bone Cements ; Cementation ; Comparative analysis ; Female ; Femoral Neck Fractures - surgery ; Fractures ; Health aspects ; Hip Prosthesis ; Humans ; Male ; Medical research ; Medicine ; Medicine &amp; Public Health ; Medicine, Experimental ; Original Article ; Orthopedics ; Prospective Studies ; Surgical Orthopedics</subject><ispartof>Musculoskeletal surgery, 2014-12, Vol.98 (3), p.205-208</ispartof><rights>Istituto Ortopedico Rizzoli 2013</rights><rights>COPYRIGHT 2014 Springer</rights><rights>Istituto Ortopedico Rizzoli 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3546-8ff8dc5e98e2bce08af37225576f47dd272c9f5cb43083e25bb0adefc2adf8ff3</citedby><cites>FETCH-LOGICAL-c3546-8ff8dc5e98e2bce08af37225576f47dd272c9f5cb43083e25bb0adefc2adf8ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23912215$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gavaskar, A. S.</creatorcontrib><creatorcontrib>Tummala, N. C.</creatorcontrib><creatorcontrib>Subramanian, M.</creatorcontrib><title>Cemented or cementless THA in patients over 80 years with fracture neck of femur: a prospective comparative trial</title><title>Musculoskeletal surgery</title><addtitle>Musculoskelet Surg</addtitle><addtitle>Musculoskelet Surg</addtitle><description>Background Total hip arthroplasty is associated with a better long term outcome and lesser reoperation rates in the elderly but the risk of complications are beleived to be higher in very elderly patients. The study aims to compare the short-term results of cemented and cementless total hip arthroplasty (THA) in active patients &gt;80 years of age with femoral neck fractures. Methods Sixty-two consecutive patients underwent THA during the study period (cemented—31 and cementless—31). The mean age was 84 years (81–94 years). Patients in both groups were comparable in their preoperative variables. Functional and radiological assessments were carried out using validated outcome measures. Complications were recorded. Results Fifty-one patients were available for final analysis after accounting for deaths and cases lost in follow-up. Of the 51 patients, 25 (49 %) regained their pre-injury mobility status and 36 (70 %) were community ambulant. Cementless THA was associated with significantly less surgical time, blood loss, transfusion rates and hospital stay. The overall mortality rates, complications, functional and radiological results were similar in both groups though the number of deaths in the perioperative period was significantly high in patients undergoing cemented THA. Conclusion Satisfactory improvement in function with low reoperation rates can be achieved irrespective of the technique used. Complication rates are higher when compared to younger patients undergoing the procedure. 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S.</au><au>Tummala, N. C.</au><au>Subramanian, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cemented or cementless THA in patients over 80 years with fracture neck of femur: a prospective comparative trial</atitle><jtitle>Musculoskeletal surgery</jtitle><stitle>Musculoskelet Surg</stitle><addtitle>Musculoskelet Surg</addtitle><date>2014-12</date><risdate>2014</risdate><volume>98</volume><issue>3</issue><spage>205</spage><epage>208</epage><pages>205-208</pages><issn>2035-5106</issn><eissn>2035-5114</eissn><abstract>Background Total hip arthroplasty is associated with a better long term outcome and lesser reoperation rates in the elderly but the risk of complications are beleived to be higher in very elderly patients. The study aims to compare the short-term results of cemented and cementless total hip arthroplasty (THA) in active patients &gt;80 years of age with femoral neck fractures. Methods Sixty-two consecutive patients underwent THA during the study period (cemented—31 and cementless—31). The mean age was 84 years (81–94 years). Patients in both groups were comparable in their preoperative variables. Functional and radiological assessments were carried out using validated outcome measures. Complications were recorded. Results Fifty-one patients were available for final analysis after accounting for deaths and cases lost in follow-up. Of the 51 patients, 25 (49 %) regained their pre-injury mobility status and 36 (70 %) were community ambulant. Cementless THA was associated with significantly less surgical time, blood loss, transfusion rates and hospital stay. The overall mortality rates, complications, functional and radiological results were similar in both groups though the number of deaths in the perioperative period was significantly high in patients undergoing cemented THA. Conclusion Satisfactory improvement in function with low reoperation rates can be achieved irrespective of the technique used. Complication rates are higher when compared to younger patients undergoing the procedure. Risks and benefits should be carefully assessed and explained before subjecting these patients to THA.</abstract><cop>Milan</cop><pub>Springer Milan</pub><pmid>23912215</pmid><doi>10.1007/s12306-013-0296-6</doi><tpages>4</tpages></addata></record>
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source Springer Nature
subjects Aged, 80 and over
Arthroplasty, Replacement, Hip - methods
Bone Cements
Cementation
Comparative analysis
Female
Femoral Neck Fractures - surgery
Fractures
Health aspects
Hip Prosthesis
Humans
Male
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Original Article
Orthopedics
Prospective Studies
Surgical Orthopedics
title Cemented or cementless THA in patients over 80 years with fracture neck of femur: a prospective comparative trial
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