Perioperative Complications after Cemented or Uncemented Hemiarthroplasty in Hip Fracture Patients

Both cemented and uncemented hemiarthroplasties are acceptable methods for treating displaced femoral neck fractures. Cemented hemiarthroplasty has traditionally been recommended as being more safe and reliable. However, the cementing process carries a risk of fat embolism and cardiovascular problems. This study attempted to determine whether these complications can be avoided when using a modern uncemented stem.

We retrospectively compared 222 hip fracture patients treated with hemiarthroplasty in our hospital. A total of 100 of these patients were treated with a hydroxyapatite-coated uncemented hemiendoprosthesis (Bi-Metric BFx) and 122 patients with a cemented hemiendoprosthesis (Lubinus SPII). Information on mortality and complications during the first 18.7 months was retrieved from patient files.

Nine perioperative fat-embolic events were found in the cemented group and none in the uncemented group. During the initial hospital treatment, there were five deaths (4.1%) in the cemented group and one death (1%) in the uncemented group. There were significantly more perioperative fractures in the uncemented versus cemented group (7% versus 0.8%). We conclude that uncemented hemiarthroplasty is associated with more perioperative fractures than cemented hemiarthroplasty. However, perioperative cardiovascular disturbances may be less frequent with uncemented hemiarthroplasty, and early mortality may be lower with uncemented hemiarthroplasty.