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Title: Long-term implant survival following hemiarthroplasty for fractured neck of femur.
Epworth Authors: de Steiger, Richard
Other Authors: Tyas, Ben
Marsh, Martin
Lorimer, Michelle
Petheram, Timothy
Inman, Dominic
Reed, Mike
Jameson, Simon
Keywords: Hip Replacement
Femur Surgery
Intracapsular Fracture
Neck Of Femur Fracture
Australian Orthopaedic Association National Joint Replacement Registry
Exeter Trauma Stem
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Aug-2023
Publisher: British Editorial Society of Bone & Joint Surgery
Citation: Bone Joint J . 2023 Aug 1;105-B(8):864-871
Abstract: Aims: Several different designs of hemiarthroplasty are used to treat intracapsular fractures of the proximal femur, with large variations in costs. No clinical benefit of modular over monoblock designs has been reported in the literature. Long-term data are lacking. The aim of this study was to report the ten-year implant survival of commonly used designs of hemiarthroplasty. Methods: Patients recorded by the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) between 1 September 1999 and 31 December 2020 who underwent hemiarthroplasty for the treatment of a hip fracture with the following implants were included: a cemented monoblock Exeter Trauma Stem (ETS), cemented Exeter V40 with a bipolar head, a monoblock Thompsons prosthesis (Cobalt/Chromium or Titanium), and an Exeter V40 with a Unitrax head. Overall and age-defined cumulative revision rates were compared over the ten years following surgery. Results: A total of 41,949 hemiarthroplasties were included. Exeter V40 with a Unitrax head was the most commonly used (n = 20,707, 49.4%). The overall rate of revision was small. A total of 28,201 patients (67.2%) were aged > 80 years. There were no significant differences in revision rates across all designs of hemiarthroplasty in patients of this age at any time. The revision rates for all designs were < 3.5%, three years postoperatively. At subsequent times the ETS and Exeter V40 with a bipolar head performed well in all age groups. The unadjusted ten-year mortality rate for the whole cohort was 82.2%. Conclusion: There was no difference in implant survival between all the designs of hemiarthroplasty in the first three years following surgery, supporting the selection of a cost-effective design of hemiarthroplasty for most patients with an intracapsular fracture of the hip, as determined by local availability and costs. Beyond this, the ETS and Exeter bipolar designs performed well in all age groups.
DOI: 10.1302/0301-620X.105B8.BJJ-2022-1150.R3
PubMed URL:
ISSN: 2049-4394
Journal Title: The Bone and Joint Journal
Type: Journal Article
Affiliated Organisations: Health Education North East, Newcastle upon Tyne, UK
Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
South Australian Health and Medical Research Institute, Adelaide, Australia.
Northumbria Healthcare NHS Foundation Trust, Cramlington, UK
South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Musculoskeletal

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