Reoperation rate and implant survivorship compared between cementless and cemented bipolar hemiarthroplasty in femoral neck fracture patients with chronic kidney disease
1
Issued Date
2022-03-01
Resource Type
ISSN
00201383
eISSN
18790267
Scopus ID
2-s2.0-85119675917
Pubmed ID
34823847
Journal Title
Injury
Volume
53
Issue
3
Start Page
1114
End Page
1121
Rights Holder(s)
SCOPUS
Bibliographic Citation
Injury Vol.53 No.3 (2022) , 1114-1121
Suggested Citation
Narkbunnam R. Reoperation rate and implant survivorship compared between cementless and cemented bipolar hemiarthroplasty in femoral neck fracture patients with chronic kidney disease. Injury Vol.53 No.3 (2022) , 1114-1121. 1121. doi:10.1016/j.injury.2021.11.010 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/87370
Title
Reoperation rate and implant survivorship compared between cementless and cemented bipolar hemiarthroplasty in femoral neck fracture patients with chronic kidney disease
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: Chronic kidney disease (CKD) is commonly associated with aging and disorders of mineral and bone metabolism. Femoral neck fracture (FNF) is one of the most common fractures among older adults with coexisting CKD, and bipolar hemiarthroplasty (BHA) is a preferred treatment. However, the optimal method of stem fixation has not been conclusively determined. Accordingly, this study aimed to investigate the reoperation rate and implant survivorship compared between cementless and cemented BHA in FNF patients with CKD. Methods: A total of 183 FNF patients with moderate to severe CKD who underwent BHA during 2003 to 2019 were recruited and divided into either the cemented (CT group, n = 56) or cementless (CL group, 127) groups. Demographic data, preoperative laboratory investigations, preoperative radiographic outcomes, perioperative outcomes, and 90-day morbidity, mortality, and reoperation rates for any reason were recorded and compared between groups. Kaplan-Meier survival analysis was used to compare implant survivorship between the CT and CL groups. Cox proportional hazards regression model was used to identify independent risk factors for implant survivorship. Results: There were no significant differences in patient characteristics or preoperative data between groups, except for Dorr's classification of proximal femoral geometry. The CT group had a significantly lower proportion of Dorr type A (p = 0.020), and a higher proportion of Dorr type C (p<0.001). The CT group also had significantly more intraoperative blood loss (p<0.01). No significant differences in morbidity or mortality were observed. The median follow-up time in the CT group and CL group was 22.6 months (range: 0–151) and 22.6 months (range 0–154), respectively (p = 0.607). The reoperation rate was 5.4% and 4.7% among CT and CL patients, respectively (p = 1.000). There was no significant difference in the mean survival time between the CT (139.5 ± 6.3 months, 95%CI: 127.1–151.8) and CL (142.5 ± 4.7 months, 95%CI: 133.2–151.7) groups (p = 0.880). Univariate and multivariate analyses revealed no independent risk factors for implant survivorship. Conclusion: The results of this study showed no significant differences in the reoperation rate or implant survivorship between cemented and cementless BHA for treating FNF in moderate to severe CKD patients. A well-designed larger and longer-term study is needed to confirm these results.