Early Prosthetic Complications After Unipolar Hemiarthroplasty

Weinrauch, Patrick C., Moore, William R., Shooter, David R., Wilkinson, Matthew P.R., Bonrath, Esther M., Dedy, Nicolas J., McMeniman, Timothy J., Jabur, Majid K.A., Whitehouse, Sarah L., & Crawford, Ross W. (2006) Early Prosthetic Complications After Unipolar Hemiarthroplasty. ANZ Journal of Surgery, 76(6), pp. 432-435.

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Background In Australia the most frequently employed hemiarthroplasty prosthesis for the management of displaced intracapsular femoral neck fractures is the Uncemented Austin Moore (UAM). Despite concerns regarding poor functional outcomes and increased early revision rates associated with the UAM prosthesis, apprehension regarding the systemic side effects of polymethylmethacrylate cement implantation in the elderly patient continues to influence prosthesis selection. This study examines the incidence of early prosthesis related complications after UAM and Cemented Thompson (CT) hemiarthroplasty procedures for the management of femoral neck fractures.

Methods A multicentre retrospective review of charts and radiographs was conducted in order to determine early prosthetic complications associated with the CT and UAM prostheses over a 6 year period in five Queensland public hospitals.

Results Intraoperative periprosthetic fractures were sustained in 11.8% of UAM and 1.8% of CT implantations (p<0.0001). Intraoperative periprosthetic fractures were associated with an increased requirement for reoperation within 1 month of the index procedure (p=0.05). No statistical difference in the incidence of intraoperative periprosthetic fractures could be observed between the hospitals participating, regardless of the proportional use of each prosthesis. Early dislocation rates were similar for the UAM and CT prostheses. The intraoperative mortality rate attributable to the use of polymethylmethacrylate cement during hip hemiarthroplasty was 1/ 738 (0.14%).

Conclusions The results of this study support the use of the CT prosthesis for the management of femoral neck fractures to reduce the high incidence of intraoperative periprosthetic fractures and associated requirements for early reoperation experienced with the UAM.

Impact and interest:

18 citations in Scopus
15 citations in Web of Science®
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ID Code: 2859
Item Type: Journal Article
Refereed: Yes
Keywords: Hip, Hemiarthroplasty, Cement, Fracture
DOI: 10.1111/j.1445-2197.2006.03757.x
ISSN: 1445-1433
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Copyright Owner: Copyright 2006 Blackwell Publishing
Copyright Statement: The definitive version is available at www.blackwell-synergy.com
Deposited On: 14 Jun 2006 00:00
Last Modified: 29 Feb 2012 13:18

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