Abstract

Introduction

The purpose of this study was to evaluate the effect of the type of femoral stem fixation (cemented vs. uncemented) on the postoperative complications rate and postoperative mortality. 

Patients and Methods

Since June 2015 we maintain a prospective database of all the patients operated at our institution for proximal femoral fractures. From this database we collected all the cases of total hip replacement and hemiartroplasty for femoral neck fractures operated between June 2015 and June 2019.
Patients with fractures secondary to malignancy, high energy trauma or cases in which a monobloc stem was used were excluded.
The study outcomes were identified using information from the department database, from patient's hospital records, from the nationwide Health Data Platform (Plataforma de Dados da Saúde, PDS) and from the nationwide System for Electronic Notification of Deaths (Sistema Informático de Comunicação de Óbitos, SICO). Using these overlapping sources is possible to evaluate outcomes even if the patient received further treatment at other institutions and to know the date of death even if the patient was deceased outside our institution.
For each patient we collected information on demographical data (gender, date of birth, Body Mass Index) clinical data ( date of surgery, delay from admission to surgery, Charlston Comorbidity Index, type of femoral fixation and implant used)  and follow-up data ( mortality during inpatient stay, at 30, 90 and 365 days, implant-related complications to date, patient-related complications at 30 days).
Quantitative variables were evaluated for skewness and distribution and qualitative variables were grouped according to clinical relevance.
Univariate and multivariate logistic regression was used to test for associations between procedure and studied outcomes. Chi-squared test and Student's t-test were used to assess confounding variables.
Patients with incomplete data were excluded from the analysis.

Results

Discussion