Cemented Hemiarthroplasty for Hip Fracture Improves QOL for Those 60 and Older

Modest improvement in quality of life, fewer periprosthetic fractures seen in patients receiving cemented versus uncemented hemiarthroplasty

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THURSDAY, Feb. 10, 2022 (HealthDay News) -- The difference in health-related quality of life is modestly improved and statistically significant for patients aged 60 years or older with an intracapsular hip fracture who receive a cemented versus an uncemented hemiarthroplasty, according to a study published in the Feb. 10 issue of the New England Journal of Medicine.

Miguel A. Fernandez, Ph.D., from the University of Oxford in the United Kingdom, and colleagues conducted a multicenter trial comparing cemented and uncemented hemiarthroplasty in patients aged 60 years or older with an intracapsular hip fracture (610 and 615 patients, respectively). Health-related quality of life measured with the use of utility scores on the EuroQol Group 5-Dimension (EQ-5D) questionnaire at four months after randomization was assessed as the primary outcome.

The researchers found that the mean EQ-5D utility scores were 0.371 and 0.315 for patients assigned to the cemented and uncemented groups, respectively (adjusted difference, 0.055; 95 percent confidence interval, 0.009 to 0.101; P = 0.02). The between-group difference was similar at one month and four months, but the difference was smaller at 12 months than at four months. Mortality at 12 months was 23.9 and 27.8 percent in the cemented and uncemented groups, respectively (odds ratio for death, 0.80; 95 percent confidence interval, 0.62 to 1.05). Periprosthetic fractures occurred in 0.5 and 2.1 percent of the cemented and uncemented group participants, respectively (odds ratio [uncemented versus cemented], 4.37; 95 percent confidence interval, 1.19 to 24.00).

"Modern cemented hemiarthroplasty for hip fracture, as compared with uncemented hemiarthroplasty, will lead to modestly better health-related quality of life and fewer periprosthetic fractures," write the authors of an accompanying editorial.

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