Skip to main content
SpringerLink
Log in

Systematic review of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures in older patients

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

The purpose of this review was to assess the effectiveness and safety of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures in older patients. We searched the Cochrane Library, MEDLINE and EMBASE for published randomized clinical trials comparing cemented with uncemented hemiarthroplasty for femoral neck fractures. Eight trials assessing 1,175 hips were eligible for meta-analysis. The pooled results showed that there was no significant difference between cemented and uncemented group with regard to the mortality, reoperation rates and postoperational complications. The overall incidence of residual pain at 1 year after operation was 23.6% in the cemented prosthesis and 34.4% in the uncemented, with significant difference (relative risk 0.69, 95% CI 0.53–0.90; P = 0.007; fixed-effect models).The available evidence suggested that compared with uncemented hemiarthroplasty, cemented hemiarthroplasty in treating the elderly with displaced femoral neck fractures was not associated with a higher risk of mortality, reoperation and complications but can reduce the risk of residual pain and provide better functional results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Khan RJ, MacDowell A, Crossman P, Datta A, Jallali N, Arch BN, Keene GS (2002) Cemented or uncemented hemiarthroplasty for displaced intracapsular femoral neck fractures. Int Orthop 26:229–232

    Article  PubMed  CAS  Google Scholar 

  2. Singh GK, Deshmukh RG (2006) Uncemented Austin-Moore and cemented Thompson unipolar hemiarthroplasty for displaced fracture neck of femur—comparison of complications and patient satisfaction. Injury 37:169–174

    Article  PubMed  CAS  Google Scholar 

  3. Foster AP, Thompson NW, Wong J, Charlwood AP (2005) Periprosthetic femoral fractures—a comparison between cemented and uncemented hemiarthroplasties. Injury 36:424–429

    Article  PubMed  Google Scholar 

  4. Lausten GS, Vedel P (1982) Cementing v. not cementing the Monk endoprosthesis. Injury 13:484–488

    Article  PubMed  CAS  Google Scholar 

  5. Lo WH, Chen WM, Huang CK, Chiu FY, Chen TH, Chen CM (1994) Bateman bipolar hemiarthroplasty for displaced intracapsular femoral neck fractures. Uncemented versus cemented. Clin Orthop Relat Res 302:75–82

    PubMed  Google Scholar 

  6. Lennox IA, McLauchlan J (1993) Comparing the mortality and morbidity of cemented and uncemented hemiarthroplasties. Injury 24:185–186

    Article  PubMed  CAS  Google Scholar 

  7. Faraj AA, Branfoot T (1999) Cemented versus uncemented Thompson’s prostheses: a functional outcome study. Injury 30:671–675

    Article  PubMed  CAS  Google Scholar 

  8. Parvizi J, Ereth MH, Lewallen DG (2004) Thirty-day mortality following hip arthroplasty for acute fracture. J Bone Joint Surg Am 86-A:1983–1988

    PubMed  Google Scholar 

  9. Khan RJ, MacDowell A, Crossman P, Keene GS (2002) Cemented or uncemented hemiarthroplasty for displaced intracapsular fractures of the hip: a systematic review. Injury 33:13–17

    Article  PubMed  CAS  Google Scholar 

  10. Ahn J, Man LX, Park S, Sodl JF, Esterhai JL (2008) Systematic review of cemented and uncemented hemiarthroplasty outcomes for femoral neck fractures. Clin Orthop Relat Res 466:2513–2518

    Article  PubMed  Google Scholar 

  11. Parker MJ, Gurusamy KS, Azegami S (2010) Arthroplasties (with and without bone cement) for proximal femoral fractures in adults. Cochrane Database Syst Rev 16(6):CD001706

    Google Scholar 

  12. Higgins JPT, Green S (2008) Cochrane handbook for systematic reviews for intervention. Version 5.0.0:180. The Cochrane Collaboration. http://www.cochrane-handbook.org

  13. Higgins JPT, Green S (2008) Cochrane handbook for systematic reviews for intervention. Version 5.0.0:242–248. The Cochrane Collaboration. http://www.cochrane-handbook.org

  14. Lau J, Ioannidis JP, Schmid CH (1997) Quantitative synthesis in systematic reviews. Ann Intern Med 127(9):820–826

    PubMed  CAS  Google Scholar 

  15. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  PubMed  CAS  Google Scholar 

  16. Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558

    Article  PubMed  Google Scholar 

  17. Sterne JAC, Egger M (2001) Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 54:1046–1055

    Article  PubMed  CAS  Google Scholar 

  18. Branfoot T, Faraj AA, Porter P (2000) Cemented versus uncemented Thompson’s prosthesis: a randomised prospective functional outcome study [abstract]. Injury 31:280–281

    Google Scholar 

  19. Emery RJ, Broughton NS, Desai K, Bulstrode CJ, Thomas TL (1991) Bipolar hemiarthroplasty for subcapital fracture of the femoral neck. A prospective randomised trial of cemented Thompson and uncemented Moore stems. J Bone Joint Surg Br 73:322–324

    PubMed  CAS  Google Scholar 

  20. Figved W, Opland V, Frihagen F, Jervidalo T, Madsen JE, Nordsletten L (2009) Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures. Clin Orthop Relat Res 467:2426–2435

    Article  PubMed  Google Scholar 

  21. Harper WM, Gregg PJ (1992) The treatment of intracapsular proximal femoral fractures: a randomized prospective trial [abstract]. J Bone Joint Surg Br 74(Suppl III):282

    Google Scholar 

  22. Santini S, Rebeccato A, Bolgan I, Turi G (2005) Hip fractures in elderly patients treated with bipolar hemiarthroplasty: comparison between cemented and cementless implants. J Orthopaed Traumatol 6:80–87

    Article  Google Scholar 

  23. Sonne-Holm S, Walter S, Jensen JS (1982) Moore hemi-arthroplasty with and without bone cement in femoral neck fractures. A clinical controlled trial. Acta Orthop Scand 53:953–956

    Article  PubMed  CAS  Google Scholar 

  24. Parker MI, Pryor G, Gurusamy K (2010) Cemented versus uncemented hemiarthroplasty for intracapsular hip fractures: a randomised controlled trial in 400 patients. J Bone Joint Surg Br 92:116–122

    Article  PubMed  CAS  Google Scholar 

  25. Sadr B, Arden GP (1977) A comparison of the stability of proplast-coated and cemented Thompson prostheses in the treatment of subcapital femoral fractures. Injury 8:234–237

    Article  PubMed  CAS  Google Scholar 

  26. Jüni P, Altman DG, Egger M (2001) Systematic reviews in health care: assessing the quality of controlled clinical trials. BMJ 323:42–46

    Article  PubMed  Google Scholar 

  27. Graham SK, Martyn JP, Glyn AP (1993) Mortality and morbidity after hip fractures. BMJ 13:1248–1250

    Google Scholar 

  28. Parvizi J, Holiday AD, Ereth MH, Lewallen DG (1999) The Frank Stinchfield Award. Sudden death during primary hip arthroplasty. Clin Orthop Relat Res 369:39–48

    Article  PubMed  Google Scholar 

  29. Kopp L, Edelmann K, Obruba P, Procházka B, Blstáková K, Dzupa V (2009) Mortality risk factors in the elderly with proximal femoral fracture treated surgically. Acta Chir Orthop Traumatol Cech 76:41–46

    PubMed  CAS  Google Scholar 

  30. Petersen MB, Jørgensen HL, Hansen K, Duus BR (2006) Factors affecting postoperative mortality of patients with displaced femoral neck fracture. Injury 37:705–711

    Article  PubMed  CAS  Google Scholar 

  31. Kesmezacar H, Ayhan E, Unlu MC, Seker A, Karaca S (2010) Predictors of mortality in elderly patients with an intertrochanteric or a femoral neck fracture. J Trauma 68:153–158

    Article  PubMed  Google Scholar 

  32. Rohit RS, Ravi S, Gurpreet S, Karunanithy N, Edwards M, Sinha S, Mostofi SB, Khan F (2005) Factors affecting in-hospital mortality after fracture neck of femur. Do cemented and uncemented hemiarthroplasty differ? J Bone Joint Surg Br 87-B(supp-I):47

    Google Scholar 

  33. Donaldson AJ, Thomson HE, Harper NJ, Kenny NW (2009) Bone cement implantation syndrome. Br J Anaesth 102:12–22

    Article  PubMed  CAS  Google Scholar 

  34. Holt EM, Evans RA, Hindley CJ, Metcalfe JW (1994) 1000 femoral neck fractures: the effect of pre-injury mobility and surgical experience on outcome. Injury 25:91–95

    Article  PubMed  CAS  Google Scholar 

  35. Stavrakis TA, Lyras DN, Psillakis IG, Krem NV (2009) Fractures of the femoral neck treated with hemiarthroplasty. A comparative study. Folia Med 51:34–39

    Google Scholar 

  36. Suman RK (1980) Prosthetic replacement of the femoral head for fractures of the neck of the femur: a comparative study. Injury 11:309–316

    Article  PubMed  CAS  Google Scholar 

  37. Wrighton JD, Woodyard JE (1971) Prosthetic replacement for subcapital fractures of the femur: a comparative survey. Injury 2:287–293

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, The People’s Hospital of Leiyang, Leiyang, Hunan, China

    Xiangping Luo, Shunqing He & Zhian Li

  2. The First Affiliated Hospital of Guangxi Traditional Chinese Medical College, Nanning, China

    Deijia Huang

Authors
  1. Xiangping Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shunqing He
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zhian Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Deijia Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiangping Luo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Luo, X., He, S., Li, Z. et al. Systematic review of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures in older patients. Arch Orthop Trauma Surg 132, 455–463 (2012). https://doi.org/10.1007/s00402-011-1436-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-011-1436-9

Keywords

Search

Navigation