Abstract：
BACKGROUND: Femoral neck fractures (FNF) are among the most common fractures in Germany and are often treated by hemiarthroplasty (HA). The aim of this study was to compare the occurrence of aseptic revisions after cemented and uncemented HA for the treatment of FNF. Secondly, the rate of pulmonary embolism was investigated.
METHODS: Data collection for this study was performed using the German Arthroplasty Registry (EPRD). HAs after FNF were divided into subgroups stratified by stem fixation (cemented vs uncemented) and paired according to age, sex, BMI, and the Elixhauser score using Mahalanobis distance matching.
RESULTS: Examination of 18,180 matched cases showed a significantly increased rate of aseptic revisions in uncemented HA (p < 0.0001). After 1 month 2.5% of HAs with uncemented stems required an aseptic revision, while 1.5% were reported in cemented HA. After 1 and 3 years\' follow-up 3.9% and 4.5% of uncemented HA and 2.2% and 2.5% of cemented HA needed aseptic revision surgery. In particular, the proportion of periprosthetic fractures was increased in cementless implanted HA (p < 0.0001). During in-patient stays, pulmonary emboli occurred more frequently after cemented HA [0.81% vs 0.53% in cementless HA (OR: 1.53; p = 0.057)].
CONCLUSIONS: For uncemented hemiarthroplasties a statistically significantly increased rate of aseptic revisions and periprosthetic fractures was evident within a time period of 5 years after implantation. During the in-hospital stay, patients with cemented HA experienced an increased rate of pulmonary embolism, but without statistically significant results. Based on the present results, with knowledge of prevention measurements and correct cementation technique, cemented HA should be preferred when using HA in the treatment of femoral neck fractures.
BACKGROUND: The study design of the German Arthroplasty Registry was approved by the University of Kiel (ID: D 473/11).
METHODS: Level III, Prognostic.
METHODS: Data collection for this study was performed using the German Arthroplasty Registry (EPRD). HAs after FNF were divided into subgroups stratified by stem fixation (cemented vs uncemented) and paired according to age, sex, BMI, and the Elixhauser score using Mahalanobis distance matching.
RESULTS: Examination of 18,180 matched cases showed a significantly increased rate of aseptic revisions in uncemented HA (p < 0.0001). After 1 month 2.5% of HAs with uncemented stems required an aseptic revision, while 1.5% were reported in cemented HA. After 1 and 3 years\' follow-up 3.9% and 4.5% of uncemented HA and 2.2% and 2.5% of cemented HA needed aseptic revision surgery. In particular, the proportion of periprosthetic fractures was increased in cementless implanted HA (p < 0.0001). During in-patient stays, pulmonary emboli occurred more frequently after cemented HA [0.81% vs 0.53% in cementless HA (OR: 1.53; p = 0.057)].
CONCLUSIONS: For uncemented hemiarthroplasties a statistically significantly increased rate of aseptic revisions and periprosthetic fractures was evident within a time period of 5 years after implantation. During the in-hospital stay, patients with cemented HA experienced an increased rate of pulmonary embolism, but without statistically significant results. Based on the present results, with knowledge of prevention measurements and correct cementation technique, cemented HA should be preferred when using HA in the treatment of femoral neck fractures.
BACKGROUND: The study design of the German Arthroplasty Registry was approved by the University of Kiel (ID: D 473/11).
METHODS: Level III, Prognostic.
摘要：
背景：股骨颈骨折（FNF）是德国最常见的骨折之一，通常通过半髋关节成形术（HA）治疗。这项研究的目的是比较在胶结和未胶结HA治疗FNF后无菌修订的发生。其次,调查肺栓塞的发生率。
方法：本研究的数据收集使用德国关节成形术注册中心（EPRD）进行。FNF后的HAs被分为通过茎固定分层的亚组（骨水泥和非骨水泥），并根据年龄配对，性别,BMI,和使用马氏距离匹配的Elixhauser分数。
结果：对18,180个匹配病例的检查显示，未栓塞HA的无菌修正率显著增加（p<0.0001）。1个月后，有2.5％的带有非胶结茎的HAs需要进行无菌翻修，而在水泥HA中报告了1.5%。随访1年和3年后，3.9%和4.5%的非水泥HA和2.2%和2.5%的水泥HA需要无菌翻修手术。特别是,非骨水泥植入HA的假体周围骨折比例增加(p<0.0001).住院期间，骨水泥HA后肺栓塞的发生率更高[0.81％vs无水泥HA的0.53％（OR：1.53；p=0.057）]。
结论：对于非骨水泥半关节置换术，在植入后5年内，无菌翻修和假体周围骨折的发生率显著增加。住院期间,骨水泥HA患者的肺栓塞发生率增加，但没有统计学意义的结果。根据目前的结果，具有预防测量知识和正确的胶结技术，当使用HA治疗股骨颈骨折时，应首选骨水泥HA。
背景：德国关节成形术注册中心的研究设计得到了基尔大学的批准（ID：D473/11）。
方法：三级，预后。
方法：本研究的数据收集使用德国关节成形术注册中心（EPRD）进行。
结果：对18,180个匹配病例的检查显示，未栓塞HA的无菌修正率显著增加（p<0.0001）。
结论：对于非骨水泥半关节置换术，在植入后5年内，无菌翻修和假体周围骨折的发生率显著增加。
背景：德国关节成形术注册中心的研究设计得到了基尔大学的批准（ID：D473/11）。
方法：三级，
