Scholarlink

Introduction <p>The optimal fixation method in total hip arthroplasty (THA) remains under debate. While cemented fixation has been associated with a lower risk of periprosthetic fracture, uncemented fixation predominates in Japan. This study aimed to compare early postoperative complications between cemented and uncemented fixation in elective THA using a nationwide inpatient database.</p> Materials and methods <p>We identified 198,102 patients aged ≥ 65 years who underwent primary THA for osteoarthritis, osteonecrosis, or rheumatoid arthritis between December 2011 and March 2023 from the Japanese Diagnosis Procedure Combination (DPC) database. After 1:1 propensity score matching for age, sex, body mass index (BMI), and Charlson Comorbidity Index, 36,859 patients were included in each fixation cohort. Surgical and medical complications, and in-hospital mortality were compared using multivariate logistic regression.</p> Results <p>Cemented fixation was associated with a significantly lower risk of periprosthetic fracture (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.30–0.53; <i>p</i> &lt; 0.001), blood transfusion (OR, 0.76; 95% CI, 0.74–0.78; <i>p</i> &lt; 0.001), and deep vein thrombosis (OR, 0.79; 95% CI, 0.74–0.84; <i>p</i> &lt; 0.001). There were no statistically significant differences based on the predefined threshold (<i>p</i> &lt; 0.001) in dislocation, infection, pulmonary embolism, cardiac or cerebrovascular events, or in-hospital mortality between fixation types, although a trend toward higher in-hospital mortality in the cemented group was observed.</p> Conclusions <p>Cemented THA was associated with reduced rates of periprosthetic fracture, transfusion, and deep vein thrombosis without increasing other perioperative or medical complications. These findings suggest that cemented fixation may be associated with favorable short-term outcomes in selected patients.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Cemented total hip arthroplasty reduces early complications: a Japanese nationwide propensity-matched study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月2日

查看全文
  • Hidetatsu Tanaka,
  • Kunio Tarasawa,
  • Yu Mori,
  • Kazuyoshi Baba,
  • Hiroaki Kurishima,
  • Kiyohide Fushimi,
  • Toshimi Aizawa,
  • Kenji Fujimori

摘要

Introduction

The optimal fixation method in total hip arthroplasty (THA) remains under debate. While cemented fixation has been associated with a lower risk of periprosthetic fracture, uncemented fixation predominates in Japan. This study aimed to compare early postoperative complications between cemented and uncemented fixation in elective THA using a nationwide inpatient database.

Materials and methods

We identified 198,102 patients aged ≥ 65 years who underwent primary THA for osteoarthritis, osteonecrosis, or rheumatoid arthritis between December 2011 and March 2023 from the Japanese Diagnosis Procedure Combination (DPC) database. After 1:1 propensity score matching for age, sex, body mass index (BMI), and Charlson Comorbidity Index, 36,859 patients were included in each fixation cohort. Surgical and medical complications, and in-hospital mortality were compared using multivariate logistic regression.

Results

Cemented fixation was associated with a significantly lower risk of periprosthetic fracture (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.30–0.53; p < 0.001), blood transfusion (OR, 0.76; 95% CI, 0.74–0.78; p < 0.001), and deep vein thrombosis (OR, 0.79; 95% CI, 0.74–0.84; p < 0.001). There were no statistically significant differences based on the predefined threshold (p < 0.001) in dislocation, infection, pulmonary embolism, cardiac or cerebrovascular events, or in-hospital mortality between fixation types, although a trend toward higher in-hospital mortality in the cemented group was observed.

Conclusions

Cemented THA was associated with reduced rates of periprosthetic fracture, transfusion, and deep vein thrombosis without increasing other perioperative or medical complications. These findings suggest that cemented fixation may be associated with favorable short-term outcomes in selected patients.