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Monoblock hemiarthroplasties for femoral neck fractures - A part of orthopaedic history? Analysis of national registration of hemiarthroplasties 2005-2009.

Rogmark, Cecilia LU ; Leonardsson, Olof LU ; Garellick, Göran and Kärrholm, Johan (2012) In Injury 43(6). p.946-949
Abstract
This study from the Swedish Hip Arthroplasty Register (SHAR) compares cemented (Thompson(®), Exeter Trauma Stem (ETS)(®)) and uncemented (Austin-Moore(®)) monoblock hemiarthroplasties (n=1116 and 616, respectively) with modular ones (n=18,659). Austin-Moore(®) prostheses lead to more re-operations (6.7%) compared to modular implants (3.5%) and Thompson(®)/ETS(®) (2.4%). A Cox regression analysis, adjusting for other risk factors, shows twice the risk of re-operation for Austin-Moore(®) implants (CI 1.5-2.8), in particular, due to periprosthetic fracture (5.4; CI 3.2-9.1) and dislocation (1.9; CI 1.3-3.0). The Thompson(®)/ETS(®) implants do not influence the overall risk of re-operation (0.7; CI 0.5-1.2) compared to modular implants and... (More)
This study from the Swedish Hip Arthroplasty Register (SHAR) compares cemented (Thompson(®), Exeter Trauma Stem (ETS)(®)) and uncemented (Austin-Moore(®)) monoblock hemiarthroplasties (n=1116 and 616, respectively) with modular ones (n=18,659). Austin-Moore(®) prostheses lead to more re-operations (6.7%) compared to modular implants (3.5%) and Thompson(®)/ETS(®) (2.4%). A Cox regression analysis, adjusting for other risk factors, shows twice the risk of re-operation for Austin-Moore(®) implants (CI 1.5-2.8), in particular, due to periprosthetic fracture (5.4; CI 3.2-9.1) and dislocation (1.9; CI 1.3-3.0). The Thompson(®)/ETS(®) implants do not influence the overall risk of re-operation (0.7; CI 0.5-1.2) compared to modular implants and decrease the risk of re-operation due to infection (0.2;CI 0.04-0.7). An increased risk of re-operation is also seen in men, age groups 75-85 years and <75 years and after secondary fracture surgery. Both Swedish and Australian orthopaedic surgeons have decreased their use of Austin-Moore(®) implants after reports from their national arthroplasty registers identifying inferior outcome for this implant. Due to the increased risk of re-operations, it should not be used in modern orthopaedic care. Cemented Thompson(®) or ETS(®) implants could still be suitable for the oldest, low-activity patients. To finally decide if there is a place for them, patient-reported outcome must be analysed as well. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Injury
volume
43
issue
6
pages
946 - 949
publisher
Elsevier
external identifiers
  • WOS:000304045100048
  • PMID:22209383
  • Scopus:84860751899
ISSN
1879-0267
DOI
10.1016/j.injury.2011.11.022
language
English
LU publication?
yes
id
976c0fb3-2f56-4b65-929f-3a95916f5cf2 (old id 2336798)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22209383?dopt=Abstract
date added to LUP
2012-02-01 18:54:26
date last changed
2016-10-13 04:26:58
@misc{976c0fb3-2f56-4b65-929f-3a95916f5cf2,
  abstract     = {This study from the Swedish Hip Arthroplasty Register (SHAR) compares cemented (Thompson(®), Exeter Trauma Stem (ETS)(®)) and uncemented (Austin-Moore(®)) monoblock hemiarthroplasties (n=1116 and 616, respectively) with modular ones (n=18,659). Austin-Moore(®) prostheses lead to more re-operations (6.7%) compared to modular implants (3.5%) and Thompson(®)/ETS(®) (2.4%). A Cox regression analysis, adjusting for other risk factors, shows twice the risk of re-operation for Austin-Moore(®) implants (CI 1.5-2.8), in particular, due to periprosthetic fracture (5.4; CI 3.2-9.1) and dislocation (1.9; CI 1.3-3.0). The Thompson(®)/ETS(®) implants do not influence the overall risk of re-operation (0.7; CI 0.5-1.2) compared to modular implants and decrease the risk of re-operation due to infection (0.2;CI 0.04-0.7). An increased risk of re-operation is also seen in men, age groups 75-85 years and &lt;75 years and after secondary fracture surgery. Both Swedish and Australian orthopaedic surgeons have decreased their use of Austin-Moore(®) implants after reports from their national arthroplasty registers identifying inferior outcome for this implant. Due to the increased risk of re-operations, it should not be used in modern orthopaedic care. Cemented Thompson(®) or ETS(®) implants could still be suitable for the oldest, low-activity patients. To finally decide if there is a place for them, patient-reported outcome must be analysed as well.},
  author       = {Rogmark, Cecilia and Leonardsson, Olof and Garellick, Göran and Kärrholm, Johan},
  issn         = {1879-0267},
  language     = {eng},
  number       = {6},
  pages        = {946--949},
  publisher    = {ARRAY(0xb9696e0)},
  series       = {Injury},
  title        = {Monoblock hemiarthroplasties for femoral neck fractures - A part of orthopaedic history? Analysis of national registration of hemiarthroplasties 2005-2009.},
  url          = {http://dx.doi.org/10.1016/j.injury.2011.11.022},
  volume       = {43},
  year         = {2012},
}