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Cemented versus Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures

  • Original Article
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Hemiarthroplasty is the most commonly used treatment for displaced femoral neck fractures in the elderly. There is limited evidence in the literature of improved functional outcome with cemented implants, although serious cement-related complications have been reported. We performed a randomized, controlled trial in patients 70 years and older comparing a cemented implant (112 hips) with an uncemented, hydroxyapatite-coated implant (108 hips), both with a bipolar head. The mean Harris hip score showed equivalence between the groups, with 70.9 in the cemented group and 72.1 in the uncemented group after 3 months (mean difference, 1.2) and 78.9 and 79.8 after 12 months (mean difference, 0.9). In the uncemented group, the mean duration of surgery was 12.4 minutes shorter and the mean intraoperative blood loss was 89 mL less. The Barthel Index and EQ-5D scores did not show any differences between the groups. The rates of complications and mortality were similar between groups. Both arthroplasties may be used with good results after displaced femoral neck fractures.

Level of Evidence: Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Merete Finjarn, Kenneth Nilsen, Karen Bjøro, and Camilla Andersen for impeccable data collection and patient logistics; Sigmund Oswold for ambulant radiographic examinations; and Asbjørn Hjall and Wenche Sørensen for initiation support and making this trial feasible in a busy orthopaedic department.

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Authors and Affiliations

  1. Orthopaedic Centre, Ullevål University Hospital, Oslo, Norway

    Wender Figved MD, Frede Frihagen MD, Jan Erik Madsen MD, PhD & Lars Nordsletten MD, PhD

  2. Orthopaedic Department, Asker and Baerum Hospital, 1309, Rud, Norway

    Wender Figved MD, Vidar Opland MD & Tore Jervidalo MD

  3. University of Oslo, Faculty Division Ullevål University Hospital, Oslo, Norway

    Wender Figved MD, Jan Erik Madsen MD, PhD & Lars Nordsletten MD, PhD

Authors
  1. Wender Figved MD
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  2. Vidar Opland MD
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  3. Frede Frihagen MD
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  4. Tore Jervidalo MD
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  5. Jan Erik Madsen MD, PhD
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  6. Lars Nordsletten MD, PhD
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Corresponding author

Correspondence to Wender Figved MD.

Additional information

The institution of the authors has received funding from Eastern Norway Regional Health Authority (nonprofit, governmental). One or more of the authors (WF, FF, JEM, LN) have received funding from Smith & Nephew, Inc, and OrtoMedic AS (OrtoMedic market orthopaedic implants manufactured by DePuy).

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Figved, W., Opland, V., Frihagen, F. et al. Cemented versus Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures. Clin Orthop Relat Res 467, 2426–2435 (2009). https://doi.org/10.1007/s11999-008-0672-y

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  • DOI: https://doi.org/10.1007/s11999-008-0672-y

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