Cementless Hemiarthroplasty Without Femoral Calcar Reconstruction Versus Cemented Hemiarthroplasty for Unstable Intertrochanteric Fractures in octogenarians

Background The aim of this study was to compare the mid-term outcomes of cementless hemiarthroplasty without femoral calcar reconstruction with cemented hemiarthroplasty in patients aged 80 years or more. Methods From January 2015 to December 2017, 135 patients with unstable intertrochanteric fractures were retrospectively investigated, 70 patients were treated with the cemented hemiarthroplasty while 65 patients were treated with a modular long-stem cementless hemiarthroplasty without rebuilding calcar. Clinical and radiological results were analyzed. Results The 106 alive patients were followed for 62.1 ± 8.3 months, and 29 patients died during the follow-up period. No significant differences were found in terms of demographic and clinical characters of patients, weight training time, postoperative hospital stay length, postoperative ambulatory status and Harris hip score. Patients treated with cementless hemiarthroplasty had a shorter operative time, less estimated blood loss, less amount of blood transfusion and a lower one-year mortality compared with patients treated with cemented hemiarthroplasty. Conclusions Compared with cemented hemiarthroplasty, cementless hemiarthroplasty using a long modular stem without reconstruction of femoral calcar was a good choice for octogenarians with unstable intertrochanteric fractures.