Cementless short stem total hip arthroplasty in patients older than 75 years: is it feasible?

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: We report personal fees paid to one co-author (T.G.) during the conduct of the study from Zimmer Biomet, Europe and from Depuy Synthes Orthopädie Gmbh, Peter Brehm GmbH, ImplanTec GmbH outside the submitted work. We report research grants paid to our institution during the conduct of the study from Zimmer Biomet, Europe, Mathys AG Switzerland, Anika Therapeutics outside the submitted work. All other co-authors declare no financial support related or non-related to the study. 7. Eur J Orthop Surg Traumatol. 2024 Jul;34(5):2573-2580. doi: 10.1007/s00590-024-03961-3. Epub 2024 May 2. Cemented vs cementless stems for revision arthroplasties due to Vancouver B2 periprosthetic hip fracture. Lara-Taranchenko Y(1), Nomdedéu JF Jr(2), Aliaga Martínez A(2), Mimendia I(2), Barro VM(2), Collado D(2), Guerra-Farfán E(2), Hernández A(2). Author information: (1)Hospital Universitari Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain. yuri.lara93@gmail.com. (2)Hospital Universitari Vall d'Hebron, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain. PURPOSE: According to Vancouver classification, B2 type fractures are most often treated with removal of the loose stem and implantation of a long stem that bypasses the fracture site. However, there is a controversy about the stem fixation that should be used: cemented or cementless. Hence, this study aims to compare cemented and cementless stems in prosthetic revision due to Vancouver B2 (VB2) periprosthetic hip fracture. METHODS: A retrospective study was done including all the patients treated with stem exchange due to VB2 periprosthetic hip fracture in a tertiary hospital between 2015 and 2022. Patients were divided into two groups according to the stem fixation used: cemented or cementless. Functional outcomes, hospital stay, surgical time, complication rate, and mortality were compared between the two groups of patients. RESULTS: Of the 30 included patients, 13 (43.4%) were treated with cementless stems and 17 (56.7%) with cemented stems. There were no statistically significant differences in age, gender, anesthesia risk scale (ASA) or functional capacity prior to the intervention. Patients treated with cementless stems had a higher complication and reintervention rate than those treated with cemented stems: 62 and 45% versus 34 and 6% (p = 0.035; p = 0.010), respectively. Furthermore, in the group of cementless stems a higher proportion of non-union was found (53.8% vs. 17.6%; p = 0.037). Also, the hospital stay (33 vs. 24 days; p = 0.037) and the time to full weight-bearing (21 days vs. 9 days; p