Perioperative mortality after hemiarthroplasty related to fixation method

Background and purpose The appropriate fixation method for hemiarthroplasty of the hip as it relates to implant survivorship and patient mortality is a matter of ongoing debate. We examined the influence of fixation method on revision rate and mortality. Methods We analyzed approximately 25,000 hemi...

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Bibliographic Details
Published in:Acta orthopaedica 2011-06, Vol.82 (3), p.275-281
Main Authors: Costain, Darren J, Whitehouse, Sarah L, Pratt, Nicole L, Graves, Stephen E, Ryan, Philip, Crawford, Ross W
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - methods
Arthroplasty, Replacement, Hip - mortality
Australia - epidemiology
Cementation
Female
Fracture Fixation, Internal - adverse effects
Fracture Fixation, Internal - methods
Hip Fractures - surgery
Hip Prosthesis - adverse effects
Humans
Male
Postoperative Complications - mortality
Prosthesis Failure
Registries
Reoperation
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Summary:Background and purpose The appropriate fixation method for hemiarthroplasty of the hip as it relates to implant survivorship and patient mortality is a matter of ongoing debate. We examined the influence of fixation method on revision rate and mortality. Methods We analyzed approximately 25,000 hemiarthroplasty cases from the AOA National Joint Replacement Registry. Deaths at 1 day, 1 week, 1 month, and 1 year were compared for all patients and among subgroups based on implant type. Results Patients treated with cemented monoblock hemiarthroplasty had a 1.7-times higher day-1 mortality compared to uncemented monoblock components (p < 0.001). This finding was reversed by 1 week, 1 month, and 1 year after surgery (p < 0.001). Modular hemiarthroplasties did not reveal a difference in mortality between fixation methods at any time point. Interpretation This study shows lower (or similar) overall mortality with cemented hemiarthroplasty of the hip.
ISSN:1745-3674
1745-3682
DOI:10.3109/17453674.2011.584208