Purudappa Prabhudev Prasad, Berliner Zachary, Venishetty Nikit, Aggarwal Vikram, Serbin Philip, Mounasamy Varatharaj, Sambandam Senthil Nathan
Boston VA Medical Center, Boston, MA, USA.
Boston Medical Center, Boston University, Boston, MA, USA.
Arch Bone Jt Surg. 2023;11(9):582-587. doi: 10.22038/ABJS.2023.70498.3307.
This study aimed to analyze and compare the perioperative outcomes of cemented and uncemented hemiarthroplasty in elderly patients with displaced femoral neck fractures by utilizing the data from the National Inpatient Sample database.
Data from the National Inpatient Sample Database was analyzed to identify patients who underwent hemiarthroplasty following a displaced femoral neck fracture (cemented and uncemented. Demographic data, comorbidities, length of stay, total charges, and perioperative complications were analyzed.
27390 patients were identified in the cemented group and 29406 in the uncemented group. The patients who underwent uncemented hemiarthroplasty demonstrated a higher incidence of prosthetic dislocation (Odds Ratio (OR) 3.348, p < 0.001), periprosthetic mechanical complications (OR 2.597, p < 0.001), wound dehiscence (OR 2.883, p < 0.001), superficial surgical site infection (OR 2.396, p = 0.043), deep surgical site infection (OR 1.686, p < 0.001), and periprosthetic fractures (OR 2.292, p < 0.001) as compared with patients who underwent cemented hemiarthroplasty. However, patients with uncemented fixation demonstrated a lower incidence of death (OR 0.567, p < 0.001), pulmonary embolism (OR 0.565, p < 0.001), deep vein thrombosis (DVT) (OR 0.746, p < 0.001), myocardial infarction (OR 0.772, p = 0.025) and blood loss anemia (OR 0.869, p < 0.001) as compared with cemented fixation.
Our study on displaced femoral neck fractures utilizing the National Inpatient database found that uncemented hemiarthroplasty was associated with a higher incidence of perioperative surgical complications. Cemented hemiarthroplasty, however, was associated with a statistically significant higher rate of death, pulmonary embolism, deep vein thrombosis, and myocardial infarction.
本研究旨在利用国家住院样本数据库的数据，分析和比较老年移位型股骨颈骨折患者行骨水泥型和非骨水泥型半髋关节置换术的围手术期结果。
分析国家住院样本数据库中的数据，以确定行移位型股骨颈骨折半髋关节置换术（骨水泥型和非骨水泥型）的患者。分析人口统计学数据、合并症、住院时间、总费用和围手术期并发症。
骨水泥型组确定了27390例患者，非骨水泥型组确定了29406例患者。与行骨水泥型半髋关节置换术的患者相比，行非骨水泥型半髋关节置换术的患者假体脱位发生率更高（优势比（OR）3.348，p<0.001）、假体周围机械并发症发生率更高（OR 2.597，p<0.001）、伤口裂开发生率更高（OR 2.883，p<0.001）、浅表手术部位感染发生率更高（OR 2.396，p = 0.043）、深部手术部位感染发生率更高（OR 1.686，p<0.001）以及假体周围骨折发生率更高（OR 2.292，p<0.001）。然而，与骨水泥固定相比，非骨水泥固定患者的死亡发生率更低（OR 0.567，p<0.001）、肺栓塞发生率更低（OR 0.565，p<0.001）、深静脉血栓形成（DVT）发生率更低（OR 0.746，p<0.001）、心肌梗死发生率更低（OR 0.772，p = 0.025）以及失血贫血发生率更低（OR 0.869，p<0.001）。
我们利用国家住院数据库对移位型股骨颈骨折的研究发现，非骨水泥型半髋关节置换术与围手术期手术并发症的发生率较高相关。然而，骨水泥型半髋关节置换术在统计学上与更高的死亡率、肺栓塞、深静脉血栓形成和心肌梗死发生率相关。
