Posterior approach and uncemented stems increases the risk of reoperation after hemiarthroplasties in elderly hip fracture patients.
(2014) In Acta Orthopaedica 85(1). p.18-25- 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... (More)
- 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 < 75 years (HR = 1.5, CI: 1.1-2.0) and for uncemented stems. For open surgery due to dislocation, the strongest risk factor was a posterior approach (HR = 2.2, CI: 1.8-2.6). Uncemented stems in particular (HR = 3.6, CI: 2.4-5.3) and male sex increased the risk of periprosthetic fracture surgery. 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. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4290726
- author
- Rogmark, Cecilia LU ; Fenstad, Anne M ; Leonardsson, Olof LU ; Engesæter, Lars B ; Kärrholm, Johan ; Furnes, Ove ; Garellick, Göran and Gjertsen, Jan-Erik
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Orthopaedica
- volume
- 85
- issue
- 1
- pages
- 18 - 25
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:24460108
- wos:000332206100006
- scopus:84896859972
- ISSN
- 1745-3682
- DOI
- 10.3109/17453674.2014.885356
- language
- English
- LU publication?
- yes
- id
- f8d120f6-fdcf-4a38-86d1-916c794f39b0 (old id 4290726)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/24460108?dopt=Abstract
- date added to LUP
- 2016-04-01 10:02:37
- date last changed
- 2024-05-06 01:49:37
@article{f8d120f6-fdcf-4a38-86d1-916c794f39b0, 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 < 75 years (HR = 1.5, CI: 1.1-2.0) and for uncemented stems. For open surgery due to dislocation, the strongest risk factor was a posterior approach (HR = 2.2, CI: 1.8-2.6). Uncemented stems in particular (HR = 3.6, CI: 2.4-5.3) and male sex increased the risk of periprosthetic fracture surgery. 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.}}, author = {{Rogmark, Cecilia and Fenstad, Anne M and Leonardsson, Olof and Engesæter, Lars B and Kärrholm, Johan and Furnes, Ove and Garellick, Göran and Gjertsen, Jan-Erik}}, issn = {{1745-3682}}, language = {{eng}}, number = {{1}}, pages = {{18--25}}, publisher = {{Taylor & Francis}}, series = {{Acta Orthopaedica}}, title = {{Posterior approach and uncemented stems increases the risk of reoperation after hemiarthroplasties in elderly hip fracture patients.}}, url = {{http://dx.doi.org/10.3109/17453674.2014.885356}}, doi = {{10.3109/17453674.2014.885356}}, volume = {{85}}, year = {{2014}}, }