Posterior approach and uncemented stems increases the risk of reoperation after hemiarthroplasties in elderly hip fracture patients

Authors

  • Cecilia Rogmark
  • Anne M Fenstad
  • Olof Leonardsson
  • Lars B Engesæter
  • Johan Kärrholm
  • Ove Furnes
  • Göran Garellick
  • Jan-Erik Gjertsen

DOI:

https://doi.org/10.3109/17453674.2014.885356

Abstract

Background Hemiarthroplasties are performed in great numbers worldwide but are seldom registered on a national basis. Our aim was to identify risk factors for reoperation after fracture-related hemiarthroplasty in Norway and Sweden.Material and methods A common dataset was created based on the Norwegian Hip Fracture Register and the Swedish Hip Arthroplasty Register. 33,205 hip fractures in individuals > 60 years of age treated with modular hemiarthroplasties were reported for the period 2005–2010. Cox regression analyses based on reoperations were performed (covariates: age group, sex, type of stem and implant head, surgical approach, and hospital volume).Results 1,164 patients (3.5%) were reoperated during a mean follow-up of 2.7 (SD 1.7) years. In patients over 85 years, an increased risk of reoperation was found for uncemented stems (HR = 2.2, 95% CI: 1.7–2.8), bipolar heads (HR = 1.4, CI: 1.2–1.8), posterior approach (HR = 1.4, CI: 1.2–1.8) and male sex (HR = 1.3, CI: 1.0–1.6). For patients aged 75–85 years, uncemented stems (HR = 1.6, 95% CI: 1.2–2.0) and men (HR = 1.3, CI: 1.1–1.6) carried an increased risk. Increased risk of reoperation due to infection was found for patients aged Interpretation Cemented stems and a direct lateral transgluteal approach reduced the risk of reoperation after hip fractures treated with hemiarthroplasty in patients over 75 years. Men and younger patients had a higher risk of reoperation. For the age group 60–74 years, there were no such differences in risk in this material.

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Published

2014-02-01

How to Cite

Rogmark, C., Fenstad, A. M., Leonardsson, O., Engesæter, L. B., Kärrholm, J., Furnes, O., Garellick, G., & Gjertsen, J.-E. (2014). Posterior approach and uncemented stems increases the risk of reoperation after hemiarthroplasties in elderly hip fracture patients. Acta Orthopaedica, 85(1), 18–25. https://doi.org/10.3109/17453674.2014.885356