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Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years A multicenter study from the Lundbeck Foundation Centre for Fast-track Hip and Knee replacement database and the Danish Hip Arthroplasty Register

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@article{85c94e1084604dc49507fef36c6dc1d2,
title = "Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years A multicenter study from the Lundbeck Foundation Centre for Fast-track Hip and Knee replacement database and the Danish Hip Arthroplasty Register",
abstract = "Background and purpose - The use of cementless total hip arthroplasty (THA) in elderly patients is debated because of increased risk of early periprosthetic femoral fractures. However, cemented femoral components carry a risk of bone cement implantation syndrome. Hence, we compared in-hospital complications, complications leading to readmission and mortality ≤ 30 days postoperatively between hybrid/cemented (cemented femoral component) vs. cementless THA in osteoarthritis patients > 70 years.Patients and methods - This is a prospective observational cohort study in 9 centers from January 2010 to August 2017. We used 30-day follow-up from the Danish National Patient Registry, patient records, and data from the Danish Hip Arthroplasty Register. Only THAs performed as a result of osteoarthritis were included.Results - 3,368 (42%) of the THAs were cemented/hybrid and 4,728 (58%) cementless. The in-hospital complication risk was 7.7% after cemented/hybrid vs. 5.3% after cementless THA (< 0.001), statistically not significant when adjusting for comorbidities (p = 0.1). There were similar risks of complications causing readmission (5.7% vs. 6.2%) and mortality ≤ 30 days (0.2% vs. 0.3%). 15 cases (0.4%) of pulmonary embolism (PE) were found after cemented/hybrid vs. 4 (0.1%) after cementless THA (p = 0.001); none occurred within 24 hours postoperatively. 2 of the PEs after cementless THA led to mortality. Cemented/hybrid THA remained significantly associated with risk of PE (RR 3.9, p = 0.02), when adjusting for comorbidities. BMI > 35 was associated with highest risk of PE (RR 5.7, p = 0.003). The risk of periprosthetic femoral fracture was 0.2% after cemented/hybrid vs. 1.5% after cementless THA (p < 0.001) and the risk of dislocations was 1.2% after cemented/hybrid THA vs. 1.8% after cementless THA (p = 0.04).Interpretation - The higher risk of PE after cemented/hybrid THA and higher risk of periprosthetic femoral fractures and dislocations after cementless THA highlights that both medically and surgically complications are related to fixation technique and have to be considered.",
keywords = "Aged, Arthroplasty, Replacement, Hip/adverse effects, Bone Cements/therapeutic use, Female, Hip Prosthesis/adverse effects, Humans, Male, Osteoarthritis, Hip/surgery, Postoperative Complications/epidemiology, Prospective Studies, Risk Factors",
author = "Martin Lindberg-Larsen and Petersen, {Pelle Baggesgaard} and J{\o}rgensen, {Christoffer Calov} and S{\o}ren Overgaard and Henrik Kehlet and {Lundbeck Foundation Center for Fast-Track Hip and Knee Replacement Collaborative Group (Kirill Gromov, S{\o}ren Solgaard, Jens Bagger members)} and Kirill Gromov and S{\o}ren Solgaard and Jens Bagger",
note = "Publisher Copyright: {\textcopyright} 2020, {\textcopyright} 2020 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",
year = "2020",
doi = "10.1080/17453674.2020.1745420",
language = "English",
volume = "91",
pages = "286--292",
journal = "Acta Orthopaedica ",
issn = "1745-3674",
publisher = "Taylor & Francis Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years A multicenter study from the Lundbeck Foundation Centre for Fast-track Hip and Knee replacement database and the Danish Hip Arthroplasty Register

AU - Lindberg-Larsen, Martin

AU - Petersen, Pelle Baggesgaard

AU - Jørgensen, Christoffer Calov

AU - Overgaard, Søren

AU - Kehlet, Henrik

AU - Lundbeck Foundation Center for Fast-Track Hip and Knee Replacement Collaborative Group (Kirill Gromov, Søren Solgaard, Jens Bagger members)

A2 - Gromov, Kirill

A2 - Solgaard, Søren

A2 - Bagger, Jens

N1 - Publisher Copyright: © 2020, © 2020 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020

Y1 - 2020

N2 - Background and purpose - The use of cementless total hip arthroplasty (THA) in elderly patients is debated because of increased risk of early periprosthetic femoral fractures. However, cemented femoral components carry a risk of bone cement implantation syndrome. Hence, we compared in-hospital complications, complications leading to readmission and mortality ≤ 30 days postoperatively between hybrid/cemented (cemented femoral component) vs. cementless THA in osteoarthritis patients > 70 years.Patients and methods - This is a prospective observational cohort study in 9 centers from January 2010 to August 2017. We used 30-day follow-up from the Danish National Patient Registry, patient records, and data from the Danish Hip Arthroplasty Register. Only THAs performed as a result of osteoarthritis were included.Results - 3,368 (42%) of the THAs were cemented/hybrid and 4,728 (58%) cementless. The in-hospital complication risk was 7.7% after cemented/hybrid vs. 5.3% after cementless THA (< 0.001), statistically not significant when adjusting for comorbidities (p = 0.1). There were similar risks of complications causing readmission (5.7% vs. 6.2%) and mortality ≤ 30 days (0.2% vs. 0.3%). 15 cases (0.4%) of pulmonary embolism (PE) were found after cemented/hybrid vs. 4 (0.1%) after cementless THA (p = 0.001); none occurred within 24 hours postoperatively. 2 of the PEs after cementless THA led to mortality. Cemented/hybrid THA remained significantly associated with risk of PE (RR 3.9, p = 0.02), when adjusting for comorbidities. BMI > 35 was associated with highest risk of PE (RR 5.7, p = 0.003). The risk of periprosthetic femoral fracture was 0.2% after cemented/hybrid vs. 1.5% after cementless THA (p < 0.001) and the risk of dislocations was 1.2% after cemented/hybrid THA vs. 1.8% after cementless THA (p = 0.04).Interpretation - The higher risk of PE after cemented/hybrid THA and higher risk of periprosthetic femoral fractures and dislocations after cementless THA highlights that both medically and surgically complications are related to fixation technique and have to be considered.

AB - Background and purpose - The use of cementless total hip arthroplasty (THA) in elderly patients is debated because of increased risk of early periprosthetic femoral fractures. However, cemented femoral components carry a risk of bone cement implantation syndrome. Hence, we compared in-hospital complications, complications leading to readmission and mortality ≤ 30 days postoperatively between hybrid/cemented (cemented femoral component) vs. cementless THA in osteoarthritis patients > 70 years.Patients and methods - This is a prospective observational cohort study in 9 centers from January 2010 to August 2017. We used 30-day follow-up from the Danish National Patient Registry, patient records, and data from the Danish Hip Arthroplasty Register. Only THAs performed as a result of osteoarthritis were included.Results - 3,368 (42%) of the THAs were cemented/hybrid and 4,728 (58%) cementless. The in-hospital complication risk was 7.7% after cemented/hybrid vs. 5.3% after cementless THA (< 0.001), statistically not significant when adjusting for comorbidities (p = 0.1). There were similar risks of complications causing readmission (5.7% vs. 6.2%) and mortality ≤ 30 days (0.2% vs. 0.3%). 15 cases (0.4%) of pulmonary embolism (PE) were found after cemented/hybrid vs. 4 (0.1%) after cementless THA (p = 0.001); none occurred within 24 hours postoperatively. 2 of the PEs after cementless THA led to mortality. Cemented/hybrid THA remained significantly associated with risk of PE (RR 3.9, p = 0.02), when adjusting for comorbidities. BMI > 35 was associated with highest risk of PE (RR 5.7, p = 0.003). The risk of periprosthetic femoral fracture was 0.2% after cemented/hybrid vs. 1.5% after cementless THA (p < 0.001) and the risk of dislocations was 1.2% after cemented/hybrid THA vs. 1.8% after cementless THA (p = 0.04).Interpretation - The higher risk of PE after cemented/hybrid THA and higher risk of periprosthetic femoral fractures and dislocations after cementless THA highlights that both medically and surgically complications are related to fixation technique and have to be considered.

KW - Aged

KW - Arthroplasty, Replacement, Hip/adverse effects

KW - Bone Cements/therapeutic use

KW - Female

KW - Hip Prosthesis/adverse effects

KW - Humans

KW - Male

KW - Osteoarthritis, Hip/surgery

KW - Postoperative Complications/epidemiology

KW - Prospective Studies

KW - Risk Factors

UR - http://www.scopus.com/inward/record.url?scp=85083569902&partnerID=8YFLogxK

U2 - 10.1080/17453674.2020.1745420

DO - 10.1080/17453674.2020.1745420

M3 - Journal article

C2 - 32285735

VL - 91

SP - 286

EP - 292

JO - Acta Orthopaedica

JF - Acta Orthopaedica

SN - 1745-3674

IS - 3

ER -

ID: 59670980