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

Rogmark, Cecilia; Leonardsson, Olof; Garellick, Göran; Kärrholm, Johan

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

Mark

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)

Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/2336798

author

Rogmark, Cecilia ^LU ; Leonardsson, Olof ^LU ; Garellick, Göran and Kärrholm, Johan

organization

Orthopedics - Clinical and Molecular Osteoporosis Research (research group)

publishing date

2012

type

Contribution to journal

publication status

published

subject

Orthopedics

in

Injury

volume

43

issue

6

pages

946 - 949

publisher

Elsevier

external identifiers

wos:000304045100048
pmid:22209383
scopus:84860751899
pmid:22209383

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

2016-04-04 09:15:17

date last changed

2022-02-28 07:04:26

@article{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    = {{Elsevier}},
  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}},
  doi          = {{10.1016/j.injury.2011.11.022}},
  volume       = {{43}},
  year         = {{2012}},
}

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