Comparison of In-Hospital Complications Following Hybrid Versus Cementless Total Hip Arthroplasty in Elderly Patients with Osteoarthritis

Abstract The use of cementless total hip arthroplasty (THA) in elderly patients is associated with a higher risk of early periprosthetic femoral fractures, while cemented femoral components increase the risk of bone cement implantation syndrome. This study compared in-hospital complications following hybrid versus cementless THA in elderly patients with osteoarthritis. A retrospective review of cases from February 2012 to June 2023 was performed using data from the Hospital of Trauma-tology and Orthopaedics arthroplasty registry. Only primary THAs for osteoarthritis were included. A total of 773 (84.9%) patients underwent hybrid THA with cemented femoral fixation, while 138 (15.1%) underwent cementless THA. The hybrid group was older (median = 72.4 vs. 68.2 years, p < 0.001), had higher American Society of Anaesthesiologists (ASA) physical status scores (range 1–4 vs. 1–3, p = 0.022), more frequent walking aid use (46.4% vs. 21.7%, p 0.001), more preoperative thromboprophylaxis (54.7% vs. 44.9%, p = 0.034), and longer operative times (median = 80 vs. 74 minutes, p = 0.001). The overall complication rate was higher in the hybrid group (56.9% vs. 47.1%, p = 0.033). Haemodynamic reactions during acetabular cup implantation occurred more frequently in the hybrid group (29.1% vs. 15.2%, p = 0.001).