Abstract | INTRODUCTION: METHODS: Seventeen thousand one hundred thirty-eight cases of cemented femoral stems were exactly matched to noncemented fixation cases in a 1:1 fashion based on age, sex, and Charlson Comorbidity Index as reported in the American Joint Replacement Registry. Outcome variables included revision for PPFx, all-cause revision within 1 year and 90 days, and in-hospital mortality at 90 days and 1 year. The primary independent variable was femoral fixation (cemented and noncemented), and covariates included race (black, white, and others), ethnicity (Hispanic and non-Hispanic), hospital teaching status (minor, major, and nonteaching), and hospital size (number of beds: 1 to 99, 100 to 399, and ≥400). Chi square tests and multivariable logistic regression models were used for statistical analysis. RESULTS: Hip arthroplasty with a cemented stem was associated with a 30% reduction in all-cause revision at 90 days (odds ratio [OR]:0.692, confidence interval [CI]:0.558 to 0.86), a 29% reduction in revision at 1 year (OR:0.709, CI:0.589 to 0.854), and an 86% reduction in revision for PPFx (OR:0.144, CI:0.07 to 0.294). However, cemented stem fixation was associated with increased odds of in-hospital (OR: 2.232 CI: 1.644 to 3.3031), 90-day, and 1-year (OR:1.23, CI:1.135 to 1.339; and OR:1.168, CI:1.091 to 1.25, respectively) mortality. DICUSSION: In this exact match study, cemented stem fixation for femoral neck fracture was associated with a markedly reduced risk of revision for PPFx and for all-cause revision. This must be weighed against the associated increased risk in mortality, which warrants additional investigation.
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Authors | Bryan D Springer, Susan M Odum, Ayushmita De, Jeffrey B Stambough, James I Huddleston 3rd, Richard L Illgen 2nd, Alejandro Gonzalez Della Valle |
Journal | The Journal of the American Academy of Orthopaedic Surgeons
(J Am Acad Orthop Surg)
Vol. 30
Issue 24
Pg. e1591-e1598
(Dec 15 2022)
ISSN: 1940-5480 [Electronic] United States |
PMID | 36476467
(Publication Type: Journal Article)
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Copyright | Copyright © 2022 by the American Academy of Orthopaedic Surgeons. |
Topics |
- Humans
- United States
(epidemiology)
- Arthroplasty, Replacement, Hip
- Research Design
- Cohort Studies
- Femoral Neck Fractures
(surgery)
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