Does cementing the femoral component increase the risk of peri-operative mortality for patients having replacement surgery for a fracture of the neck of femur?
Concerns have been reported to the United KingdomNational Patient Safety Agency, warning that cementing the femoral componentduring hip replacement surgery for fracture of the proximal femurmay increase peri-operative mortality. The National Hip Fracture Database collects demographic and outcomedata about patients with a fracture of the proximal femur from over100 participating hospitals in the United Kingdom. We conducteda mixed effects logistic regression analysis of this dataset todetermine whether peri-operative mortality was increased in patientswho had undergone either hemiarthroplasty or total hip replacementusing a cemented femoral component. A total of 16?496 patients from129 hospitals were included in the analysis, which showed a smallbut significant adjusted survival benefit associated with cementing(odds ratio 0.83, 95% confidence interval 0.72 to 0.96). Other statisticallysignificant variables in predicting death at discharge, listed inorder of magnitude of effect, were gender, American Society of Anesthesiologistsgrade, age, walking accompanied outdoors and arthroplasty. Interactionterms between cementing and these other variables were sequentiallyadded to, but did not improve, the model. This study has not shown an increase in peri-operative mortalityas a result of cementing the femoral component in patients requiringhip replacement following fracture of the proximal femur.
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