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- Talk
- 10/06/2022
- CANADA
Surgeon Volume in its Relationship to Revision Rates per Cementless and Cemented Hip Fractures in Canada
Description
In a recent presentation by Armideo Falsetto on hip hemiarthroplasty, the discussion centered around the comparative analysis of cemented versus cementless stem options. Falsetto noted that while both options exist, international registries advocate for cemented stems, especially for femoral neck fractures. He highlighted that literature consistently shows cementless stems carry a higher revision and periprosthetic fracture risk. Referencing a Danish registry study, he demonstrated the increased revision risk associated with uncemented stems.
Furthermore, he analyzed data from systematic reviews and the results indicated that the use of cemented stems correlates with a lower incidence of intraoperative and postoperative fractures. Falsetto pointed out that concerns about increased mortality associated with cemented stems have not been substantiated by the literature, which shows no significant difference in mortality within a 30-day postoperative period.
The study conducted by the Dalhousie group also revealed that cemented hemiarthroplasty yields better quality of life outcomes compared to uncemented alternatives. He noted a gap in existing studies specific to orthopedic practice variations, particularly concerning surgeon experience and its impact on revision rates between cemented and cementless options.
His research utilized the Canadian Joint Replacement Registry, encompassing data from 2012 to 2020, aimed to discern the impact of surgeon volume on revision risks. The findings consistently affirmed that both low and high-volume surgeons exhibit a significant revision risk when utilizing cementless stems over cemented stems, regardless of their experience.
Falsetto concluded that cemented stems remain the safest option for hip hemiarthroplasty, with lower revision risks, emphasizing the importance of enhancing training and education surrounding cement techniques in orthopedic practice.