COMPARISION STUDY OF CEMENTED VERSUS UNCEMENTED JRI BIPOLAR HEMIARTHROPLASTY IN FRACTURE NECK OF FEMUR

Abstract

Introduction: Surgeries in elderly individuals should be less invasive and less time consuming to reduce immediate postoperative morbidity and mortality. Nevertheless it should also give optimal long-term outcome thereby avoiding subsequent procedures in these high risk individuals. Bipolar hemiarthroplasty is a commonly performed orthopaedic surgery in elderly patients with fracture neck of femur. It is commonly believed that the type of implant and the nature of fixation (cemented or uncemented) influences both the short term and the long term outcome of this procedure. In this retrospective study we compared uncemented and cemented JRI furlong prosthesis.

Method and materials: We had cohort of 60 patients who underwent cemented JRI bipolar hemiarthroplasty in the year of 2003 and 2004. We compared this cohort with the matched sample of 60 patients who underwent uncemented JRI bipolar hemiarthroplasty. We matched variables like age, ASA grade and the experience of surgeon.

Results and Discussion: The perioperative variables like duration of surgery, amount of blood loss, length of hospital stay and postoperative complications (DVT, chest infection, mortality) were found to be less in the uncemented JRI group. However there are concerns about the long-term outcome of uncemented JRI hemi-arthroplasty in the form of peri prosthetic fractures. Out of 60 patients of uncemented JRI group 3 had peri prosthetic fracture as compared to none in the cemented JRI group. We believe this complication more likely could be due to excessive canal preparation and the press fit necessary for the primary stability of the implant. This warrants further prospective controlled trials to provide more evidence on this finding.