Abstract
Introduction
This study aimed to investigate the survival rate, postoperative complications, and
walking ability in cemented hemiarthroplasty (HA) for displaced femoral neck fractures
according to the anaesthesia method.
Methods
We conducted a retrospective study of a multicentre group (the TRON group). Three
hundred fifty-eight patients who underwent cemented HA between 2015 and 2019 were
selected; 289 patients of ≥75 years of age with no missing data were included. Patient
background factors were matched and patients were assigned to spinal anaesthesia (SA)
and general anaesthesia (GA) groups. The primary outcome was death at any time during
the follow-up period. Secondary outcomes included postoperative complications and
walking ability assessed using the Parker mobility score (PMS). Overall survival was
evaluated using the Kaplan–Meier method, and differences were compared using the log-rank
test. The incidence of each complication and PMS were compared between the two groups
using Fisher's exact test.
Results
Overall survival during follow-up was significantly higher in the SA group in comparison
to the GA group (p = 0.037). In the SA and GA groups, the survival rate at 3 months
postoperatively was 98.4% and 95.5%, respectively. The incidence of postoperative
pneumonia was significantly higher in the GA (p = 0.012), and PMS at 3 months postoperatively
was significantly higher in the SA group (p = 0.016).
Conclusion
The survival rate of elderly patients who underwent cemented HA was better in the
SA group. General anaesthesia in cemented HA may be associated with lower life expectancy,
increased incidence of pneumonia, and decreased walking ability.
Keywords
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Article info
Publication history
Published online: February 21, 2023
Accepted:
February 7,
2023
Received in revised form:
January 30,
2023
Received:
November 2,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
