Implant-related complications following hip hemiarthroplasty: a comparison of modern cemented and uncemented prostheses

Abstract

Fractured neck of femurs is a very common presentation to hospital, especially in an elderly population and in almost all cases requires an operation, usually a cemented or uncemented hemiarthroplasty. Current evidence and multiple guidance issued in UK suggest the use of cemented hemiarthroplasty above uncemented prostheses. This retrospective case series performed in District General Hospital in Wales, UK. Notes and radiographs of 80 consecutive patients who had hemiarthroplasty for the fracture of neck of femur were examined by independent observer. All patients received modern prosthesis—collarless, polished tapered cemented stem or fully HA-coated uncemented stem—based on the choice of treating consultant. There were 47 uncemented prostheses and 33 cemented hemiarthroplasties used. We identified 12 significant complications in the uncemented group (26 %) as compared to three in the cemented group (6 %). The most significant difference was periprosthetic fracture rate, with five in the uncemented group (10.7 %) as compared to none in the cemented group. There were a total of six reoperations in four patients all of whom had initially undergone uncemented operations. In both groups, 24-h mortality rate was similar. Our study supports the use of modern cemented prosthesis as opposed to modern uncemented hemiarthroplasty. Post-operative complication rate after uncemented prosthesis is unacceptably high, especially periprosthetic fracture rate.