Cemented versus uncemented hemiarthroplasty for femoral neck fractures in elderly patients

Nikil Sanaba Paramesh; Usman Taufiq

doi:10.18203/issn.2455-4510.IntJResOrthop20191784

Authors

Nikil Sanaba Paramesh Department of Orthopaedics, Dr B R Ambedkar Medical College, Bangalore, Karnataka, India
Usman Taufiq Department of Orthopaedics, Dr B R Ambedkar Medical College, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20191784

Keywords:

Femoral neck fractures, Cemented hemiarthoplasty, Uncemented hemiarthoplasty, Bipolar prosthesis

Abstract

Background: Controversy still exists regarding using cemented or uncemented hemiarthroplasty for femoral neck fractures in elderly patients. The aim of this study is to compare the effectiveness and safety of the two surgical techniques in femoral neck fracture patients over 60 years old.

Methods: We searched PUBMED from inception to December 2012 for relevant randomized controlled trials (RCTs). Outcomes of interest include postoperative hip function, residue pain, complication rates, mortality, reoperation rate, operation time and intraoperative blood loss. Odds ratios (OR) and weighted mean differences (WMD) from each trial were pooled using random-effects model or fixed-effects model given on the heterogeneity of the included studies.

Results: Our control trial involved 132 patients (132 hips) who were eligible for the study. Our results demonstrate that cemented hemiarthroplasty is associated with better postoperative hip function (OR = 0.48, 95% CI, 0.31–0.76; p = 0.002), lower residual pain (OR = 0.43, 95%CI, 0.29–0.64; p<0.0001), less implant-related complications (OR = 0.15, 95%CI, 0.09–0.26; p<0.00001) and longer operation time (WMD = 7.43 min, 95% CI, 5.37–9.49 min; p<0.00001). No significant difference was observed between the two groups in mortality, cardiovascular and cerebrovascular complications, local complications, general complications, reoperation rate and intraoperative blood loss.

Conclusions: Compared with uncemented hemiarthroplasty, the existing evidence indicates that cemented hemiarthroplasty can achieve better hip function, lower residual pain and less implant-related complications with no increased risk of mortality, cardiovascular and cerebrovascular complications, general complications, local complications and reoperation rate in treating elderly patients with femoral neck fractures.

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