AB115. SOH25_AB_232. Back to the future: a comparison of institutional learning curves and intraoperative fracture rates associated with adoption of a cemented and uncemented stem
Orthopaedic Session I

AB115. SOH25_AB_232. Back to the future: a comparison of institutional learning curves and intraoperative fracture rates associated with adoption of a cemented and uncemented stem

Kieran Field, Orla Hennessy, Flynn Sean, Fiachra Rowan, Eoghan Pomeroy, May Cleary

Department of Orthopaedics and Trauma, University Hospital Waterford, Waterford, Ireland

Background: This study reviews the learning curves and complication rates when adopting new hemiarthroplasty stem designs into practice.

Methods: This retrospective study compared outcomes across three hemiarthroplasty stem designs used over different periods in our trauma unit. The first was a cemented taper-slip stem (CTSS), then an uncemented stem (UCS), and later to a composite beam cemented stem (CBCS). Radiographs were analysed for alignment, sizing, and fractures.

Results: Our study included 151 CTSCs. The first 50 CTSSs had a complication rate of 10% (five stems were misaligned). As this was after many years of using this stem, this could be considered our baseline complication rate. The remaining 101 CTSSs were undertaken after an almost one-year hiatus and had a complication rate of 11% (nine misaligned and two fractures). We included 124 UCSs. The first 50 UCSs had a complication rate of 34% (including 15 undersized stems and one post-operative fractures). The remaining 74 UCSs had a complication rate of 41.9% (including 26 undersized stems, seven intraoperative and one post-operative fractures). We included 138 CBCSs. The first 50 CBCSs had a complication rate of 34% (including 17 misaligned stems and one post-operative fracture). The remaining 88 CBCSs had a complication rate of 7.9% (including seven misaligned stems).

Conclusions: Our findings align with broader evidence indicating higher fracture rates in uncemented hemiarthroplasty. Through weekly trauma reviews, our unit identified consistently high complication rates with UCSs supporting a return to cemented options which then had a shorter learning curve.

Keywords: Hemiarthorplasty; cemented; uncemented; complication-rates; retrospective study

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab115
Cite this abstract as: Field K, Hennessy O, Sean F, Rowan F, Pomeroy E, Cleary M. AB115. SOH25_AB_232. Back to the future: a comparison of institutional learning curves and intraoperative fracture rates associated with adoption of a cemented and uncemented stem. Mesentery Peritoneum 2025;9:AB115.

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