Abstract
Objectives
To compare the outcomes of cemented and uncemented hemiarthroplasty for treating displaced femoral neck fractures.
Method
We searched the PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases from 1966 to Mar 2012. No language restriction was applied. Reference lists of all the selected articles were hand-searched for any additional trials. Trial quality was assessed using the modified Jadad Scale. Two authors independently extracted data from all eligible studies, including study design, participants, interventions, and outcomes (mortality, hospital stay, blood loss, operation time, residual pain, and complications). The data were using fixed-effects and random-effects models with mean differences and risk ratios for continuous and dichotomous variables, respectively.
Results
A total of 12 studies involving 1805 patients were identified in this analysis. Meta-analysis showed longer operation time (SMD, −0.43, 95 % CI −0.56, −0.30) in cemented versus uncemented hemiarthroplasty. There was no significant difference between the two treatment groups regarding mortality (OR, 1.08, 95 % CI 0.88, 1.34), hospital stay (SMD, −1.21, 95 % CI −2.24, −0.18), blood loss (SMD, −0.12, 95 % CI −0.33, 0.10), operation time (SMD, −0.43, 95 % CI −0.56, −0.30), residual pain (OR, 1.42, 95 % CI 0.99, 2.03), and complications (OR, 0.82, 95 % CI 0.63, 1.08).
Conclusions
The available evidence suggested there was no significant difference between uncemented and cemented hemiarthroplasty in treating displaced femoral neck fractures.
Similar content being viewed by others
References
Cheng SY, Levy AR, Lefaivre KA, Guy P, Kuramoto L, Sobolev B (2011) Geographic trends in incidence of hip fractures: a comprehensive literature review. Osteoporos Int 22(10):2575–2586
Wittich A, Bagur A, Mautalen C, Cristofari A et al (2010) Epidemiology of hip fracture in Tucuman, Argentina. Osteoporos Int 21(11):1803–1807
Johansson H, Clark P, Carlos F, Oden A, McCloskey EV, Kanis JA (2011) Increasing age- and sex-specific rates of hip fracture in Mexico: a survey of the Mexican Institute of Social Security. Osteoporos Int 22(8):2359–2364
Lefaivre KA, Levy AR, Sobolev B, Cheng SY, Kuramoto L, Guy P (2011) Changes in first hip fracture rates in British Columbia Canada, 1990–2004. Osteoporos Int 22(11):2817–2827
Cooper C, Campion G 3rd, Melton LJ 3rd (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2(6):285–289
Bhandari M, Devereaux PJ, Tornetta TP 3rd, Swiontkowski MF et al (2005) Operative management of displaced femoral neck fractures in elderly patients. An international survey. J Bone Joint Surg Am 87(9):2122–2130
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(4):229–232
Skyrme AD, Jeer PJ, Berry J, Lewis SG, Compson JP (2001) Intravenous polymethyl methacrylate after cemented hemiarthroplasty of the hip. J Arthroplasty 16(4):521–523
Fallon KM, Fuller JG, Morley-Forster P (2001) Fat embolization and fatal cardiac arrest during hip arthroplasty with methylmethacrylate. Can J Anaesth 48(7):626–629
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
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(1):116–122
Stavrakis TA, Lyras DN, Psillakis IG, Kremmydas NV et al (2009) Fractures of the femoral neck treated with hemiarthroplasty. A comparative study. Folia Med (Plovdiv) 51(4):34–39
Moroni A, Pegreffi F, Romagnoli M, Hoang-Kim A, Tesei F, Giannini (2009) Result in osteoporotic femoral neck fractures treated with cemented versus uncemented hip arthroplasty. J Bone Joint Surg Br 91-B(SUPP I):167
Taylor F, Wright M, Zhu M (2012) Hemiarthroplasty of the Hip with and without Cement: a randomized clinical trial. J Bone Joint Surg Am 94(7):577–583
Hansen SK, Brix M, Birkelund L, Troelsen A (2010) Can introduction of an uncemented, hydroxyapatite coated hemiarthroplasty for displaced femoral neck fractures be recommended. Hip Int 20(1):109–114
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(9):2426–2435
Deangelis JP, Ademi A, Staff I, Lewis CG (2012) Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: a prospective randomized trial with early follow-up. J Orthop Trauma 26(3):135–140
Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17(1):1–12
Cumming D, Parker M (2012) Randomised trial of cemented versus uncemented hemiarthroplasty for displaced intracapsular fractures. J Bone Joint Surg Br 94-B(SUPP III):63
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(6):953–956
Dorr LD, Glousman R, Hoy AL, Vanis R, Chandler R (1986) Treatment of femoral neck fractures with total hip replacement versus cemented and noncemented hemiarthroplasty. J Arthroplasty 1(1):21–28
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(2):322–324
Harper WM, Gregg PJ (1992) The treatment of intracapsular proximal femoral fractures: a randomized prospective trial. J Bone Joint Surg Br 74(Suppl III):282
Branfoot T, Faraj AA, Porter P (2000) Cemented versus uncemented Thompson’s prosthesis: a randomised prospective functional outcome study. Injury 31:280–281
Azegami S, Gurusamy KS, Parker MJ (2011) Cemented versus uncemented hemiarthroplasty for hip fractures: a systematic review of randomised controlled trials. Hip Int 21(5):509–517
Luo X, He S, Li Z, Huang D (2012) Systematic review of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures in older patients. Arch Orthop Trauma Surg 132(4):455–463
Conflict of interest
The authors declare no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
Guang-Zhi Ning, Yu-Lin Li contributed equally to this work and should be considered co-first authors.
Rights and permissions
About this article
Cite this article
Ning, GZ., Li, YL., Wu, Q. et al. Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: an updated meta-analysis. Eur J Orthop Surg Traumatol 24, 7–14 (2014). https://doi.org/10.1007/s00590-012-1151-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00590-012-1151-4