This study from the Swedish Hip Arthroplasty Register (SHAR) compares cemented (Thompson®, Exeter Trauma Stem (ETS)®) and uncemented (Austin-Moore®) monoblock hemiarthroplasties (n = 1116 and 616, respectively) with modular ones (n = 18,659). Austin-Moore® prostheses lead to more re-operations (6.7%) compared to modular implants (3.5%) and Thompson®/ETS® (2.4%). A Cox regression analysis, adjusting for other risk factors, shows twice the risk of re-operation for Austin-Moore® implants (CI 1.5-2.8), in particular, due to periprosthetic fracture (5.4; CI 3.2-9.1) and dislocation (1.9; CI 1.3-3.0). The Thompson®/ETS® implants do not influence the overall risk of re-operation (0.7; CI 0.5-1.2) compared to modular implants and decrease the risk of re-operation due to infection (0.2;CI 0.04-0.7). An increased risk of re-operation is also seen in men, age groups 75-85 years and <75 years and after secondary fracture surgery. Both Swedish and Australian orthopaedic surgeons have decreased their use of Austin-Moore® implants after reports from their national arthroplasty registers identifying inferior outcome for this implant. Due to the increased risk of re-operations, it should not be used in modern orthopaedic care. Cemented Thompson® or ETS® implants could still be suitable for the oldest, low-activity patients. To finally decide if there is a place for them, patient-reported outcome must be analysed as well. © 2011 Elsevier Ltd. All rights reserved.
Rogmark, C., Leonardsson, O., Garellick, G., & Kärrholm, J. (2012). Monoblock hemiarthroplasties for femoral neck fractures - A part of orthopaedic history? Analysis of national registration of hemiarthroplasties 2005-2009. Injury, 43(6), 946–949. https://doi.org/10.1016/j.injury.2011.11.022