Long-term follow-up outcomes for patients undergoing primary total hip arthroplasty with uncemented versus cemented femo
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(2019) 14:371
RESEARCH ARTICLE
Open Access
Long-term follow-up outcomes for patients undergoing primary total hip arthroplasty with uncemented versus cemented femoral components: a retrospective observational study with a 5-year minimum follow-up Tiejian Liu1†, Xiaoxiao Hua2†, Weiguang Yu3, Jinluan Lin4, Mingdong Zhao5*, Jun Liu6* and Xianshang Zeng3*
Abstract Background: This retrospective analysis compared the long-term outcomes for patients with a femoral neck fracture (AO/OTA type 31B) treated with a primary unilateral total hip arthroplasty with uncemented or cemented femoral components (UTHA or CTHA, respectively). Methods: We conducted a retrospective cohort study using the South China Hip Arthroplasty Database. We identified 422 patients with femoral neck fracture (AO/OTA type 31B) who were previously treated with primary unilateral UTHA or CTHA between 2007 and 2015, with follow-up until 2019. Follow-up occurred 1, 3, 6 and 12 months postoperatively and yearly thereafter. The primary outcome was the Harris hip score (HHS). The secondary outcome was the orthopaedic complication rate. Results: In total, 324 patients (UTHA n = 160, mean age 68.61 ± 7.49 years; CTHA n = 164, mean age 68.75 ± 7.04 years) were evaluated for study eligibility. The median follow-up was 73.3 months (range, 11.6–89.2 months). At the final follow-up, HHS was 74.09 ± 6.23 vs 79.01 ± 10.21 (UTHA vs CTHA, p = 0.012). Significant differences were detected in the incidence of prosthetic revision, loosening, and periprosthetic fracture between the UTHA and CTHA groups (7.5% for UTHA vs 1.8% for CTHA, p = 0.015; 17.5% for UTHA vs 8.5% for CTHA, p = 0.016; 11.9% for UTHA vs 4.9% for CTHA, p = 0.021, respectively). Conclusion: In this setting, CTHA demonstrated superiority to UTHA by improving functional outcomes and decreasing complication rates. Keywords: Uncemented, Cemented, Total hip arthroplasty, Femoral neck fracture, Complication
* Correspondence: [email protected]; [email protected]; [email protected] † Tiejian Liu and Xiaoxiao Hua contributed equally to this work. 5 Department of Orthopaedics, Jinshan Hospital, Fudan University, Longhang Road No. 1508, Jinshan District, Shanghai City 201508, China 6 Department of Gynaecology and Obstetrics, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China 3 Department of Orthopaedics, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China Full list of author information is available at the end of the article
Background Femoral neck fractures potentially lead to catastrophic physical and functional impairment [1–4]. The demand for total hip arthroplasty (THA), which is an exceedingly successful surgery for femoral neck fractures, has gradually climbed in the elderly [1] and could increase by 174% by 2030 [5]. The increase in demand may also be contributing to the escalated implant-related failure rate. Total hip arthroplasty with an uncemented or
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