Cemented Versus Uncemented Hemiarthroplasty for the Management of Femoral Neck Fractures in the Elderly: a Meta-analysis and Systematic Review

Overview

Journal Arch Orthop Trauma Surg

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2021 Jan 10

PMID 33423078

Citations 6

Authors

Lang Li

Xue Zhao

Xiaodong Yang

Lei Yang

Fei Xing

Xueyang Tang

Affiliations

Soon will be listed here.

Abstract

Introduction: Hemiarthroplasty is commonly used to treat unstable femoral neck fractures in older patients. However, there is no consensus on the use of cement during hemiarthroplasty. Therefore, we performed a systematic review to focus on the outcomes of cemented and uncemented hemiarthroplasty for the treatment of femoral neck fractures in older patients.

Materials And Methods: Pubmed, Cochrane Central Register of Controlled Trials, and Ovid were searched for studies related comparison of cemented versus uncemented hemiarthroplasty for unstable femoral neck fractures from inception to Jan 20, 2020. The quality of the included randomized controlled trials (RCTs) was assessed using the Cochrane Collaboration tool. The meta-analysis was performed using the RevMan 5.2 software.

Results: Eleven RCTs were included in the meta-analysis. Cemented hemiarthroplasty was found to be superior to uncemented arthroplasty with respect to reoperation rate (RR 0.6, 95% CI 0.38-0.96, p = 0.03), complications related to prosthesis (RR 0.39, 95% CI 0.23-0.68, p = 0.0008), residual pain (RR 0.66, 95% CI 0.52-0.83, p = 0.0004), and operation time (MD 8.22, 95% CI 6.30-10.14, p < 0.00001). There were no significant between-group differences with respect to local and general complications, duration of hospital stay, hip function, and mortality.

Conclusions: This meta-analysis showed cemented hemiarthroplasty might be an optimum choice for treating unstable femoral neck fractures in older patients. However, the results of this meta-analysis should be interpreted cautiously owing to some limitations. Further studies are required to provide more robust evidence.

Citing Articles

Samaheen M, Mohammad M, Salzmann M, Ramadanov N Orthop Surg. 2024; 17(2):361-372.

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Effect of cemented vs uncemented on outcomes for hemiarthroplasty in the elderly: A meta-analysis of randomized clinical trials.

Feng Y, Wan J, Deng H, Chen L, Xiao Y, Li T Medicine (Baltimore). 2024; 103(37):e39562.

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Periprosthetic fractures: an unrecognized osteoporosis crisis.

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Cemented vs Uncemented hemiarthroplasties for femoral neck fractures: An overlapping systematic review and evidence appraisal.

Reddy A, Scott J, Norris G, Moore C, Checketts J, Hughes G PLoS One. 2023; 18(2):e0281090.

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The Influence of a Modified 3rd Generation Cementation Technique and Vaccum Mixing of Bone Cement on the Bone Cement Implantation Syndrome (BCIS) in Geriatric Patients with Cemented Hemiarthroplasty for Femoral Neck Fractures.

Bokeler U, Buhler A, Eschbach D, Ilies C, Liener U, Knauf T Medicina (Kaunas). 2022; 58(11).

PMID: 36363544 PMC: 9696240. DOI: 10.3390/medicina58111587.

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