Observational studyActa orthopaedica2021
Uncemented or cemented stems in first-time revision total hip replacement? An observational study of 867 patients including assessment of femoral bone defect size.
Observational study in Acta orthopaedica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Outcomes and complications of conversion THA after internal fixation of proximal femur fractures: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Cemented versus uncemented fixation of femoral components in 2-stage hip revision arthroplasty to treat periprosthetic joint infection: a cohort study on 94 patients comparing the risks for relapse and reoperation.Acta orthopaedica · 2025Article
- Cementless one-stage hip revision arthroplasty with an injectable antibiotic bone graft substitute : a pilot study.Bone & joint open · 2025Article
- Long-term implant survival, functional, and radiological assessment of cemented stem in revision hip arthroplasty.International orthopaedics · 2025Article
- Review
- Impact of fixation method on femoral bone loss: a retrospective evaluation of stem loosening in first-time revision total hip arthroplasty among two hundred and fifty five patients.International orthopaedics · 2024Article
- Comparative analysis of femoral bone loss: uncemented vs. cemented aseptic stem loosening in first-time revision surgery-a retrospective evaluation of 215 patients.Archives of orthopaedic and trauma surgery · 2024Article
- Comparative outcomes of uncemented and cemented stem revision in managing periprosthetic femoral fractures: a retrospective cohort study.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2024Article
- Cemented vs cementless stems for revision arthroplasties due to Vancouver B2 periprosthetic hip fracture.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- [Cement in revision arthroplasty-what about the "glacier effect"? : Case studies viewed from different perspectives].Orthopadie (Heidelberg, Germany) · 2024Review
- A review of the design, manufacture, and outcomes of custom total joint replacement implants available in the United States.Journal of clinical orthopaedics and trauma · 2024Review
- Does size matter? Outcomes following revision total hip arthroplasty with long or primary stems: a systematic review and meta-analysis.Arthroplasty (London, England) · 2024Article
- CementedWorld journal of orthopedics · 2023Article
- Two-stage revision for periprosthetic joint infection in cemented total hip arthroplasty: an increased risk for failure?Archives of orthopaedic and trauma surgery · 2023Review
- Downsizing in total hip arthroplasty. A short stem as a revision implant.Der Orthopade · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Uncemented stems are gradually replacing cemented stems in hip revision surgery. We compared the risk of re-revision between uncemented and cemented revision stems and assessed whether the different fixation methods are used in similar femoral bone defects.Patients and methods - 867 patients operated on with uncemented or cemented stems in first-time hip revision surgery due to aseptic loosening performed 2006-2016 were identified in the Swedish Hip Arthroplasty Register. Preoperative femoral bone defect size was assessed on radiographs of all patients. Cox regression models were fitted to estimate the adjusted risk of re-revision during different postoperative time periods. Re-revision of any component for any reason, and stem re-revision, as well as risk of cause-specific re-revision was estimated.Results - Most patients in both fixation groups had Paprosky class IIIA femoral bone defects prior to surgery, but there were more severe bone defects in the cemented group. The adjusted risk of re-revision of any component for any reason was higher in patients with uncemented compared with those with cemented revision stems during the first 3 years after index surgery (hazard ratio [HR] 4, 95% confidence interval [CI] 2-9). From the 4th year onward, the risk of re-revision of any component for any reason was similar (HR 0.5, CI 0.2-1.4). Uncemented revision stems conferred a higher risk of dislocation compared with cemented stems (HR 5, CI 1.2-23) during the first 3 years.Interpretation - Although not predominantly used in more complex femoral defects, uncemented revision stem fixation confers a slightly higher risk of re-revision during the first years, but this risk is attenuated after longer follow-up.
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