Abstract
AIMS: Our aim was to prepare a systematic review and meta-analysis to compare the outcomes of cemented and cementless hemiarthroplasty of the hip, in elderly patients with a fracture of the femoral neck, to investigate the mortality, complications, length of stay in hospital, blood loss, operating time and functional results.
MATERIALS AND METHODS: A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on randomised controlled trials (RCTs), studying current generation designs of stem only. The synthesis of results was done of pooled data, with a fixed effects or random effects model, based on heterogeneity.
RESULTS: A total of five RCTs including 950 patients (950 hips) were included. Cementless stems were found to be associated with more complications compared with cemented stems (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.12 to 2.31, p = 0.01), especially implant-related complications (OR 3.15, 95% CI 1.55 to 6.41, p = 0.002). The operating time was shorter for cementless stems (weighted mean difference -9.96 mins, 95%CI -12.93 to -6.98, p < 0.001). The data on functional outcomes could not be pooled. There was no statistically significant difference for any other outcome between the two methods of fixation.
CONCLUSION: In hemiarthroplasty of the hip using current generation stems, cemented stems result in fewer implant-related complications and similar mortality compared with cementless stems. Cite this article:Bone Joint J2017;99-B:421-31.
Original language | English |
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Pages (from-to) | 421-431 |
Number of pages | 11 |
Journal | The Bone & Joint Journal |
Volume | 99-B |
Issue number | 4 |
DOIs | |
Publication status | Published - Apr 2017 |
Keywords
- Arthroplasty, Replacement, Hip
- Blood Loss, Surgical
- Bone Cements
- Cementation
- Femoral Neck Fractures
- Hemiarthroplasty
- Hip Prosthesis
- Humans
- Length of Stay
- Prosthesis Design
- Randomized Controlled Trials as Topic
- Reoperation
- Journal Article
- Meta-Analysis
- Review
- MORTALITY
- BONE-CEMENT
- FOLLOW-UP
- BIPOLAR HEMIARTHROPLASTY
- PROSTHESES
- FIXATION
- UNCEMENTED HEMIARTHROPLASTY
- PROSPECTIVE RANDOMIZED-TRIAL
- ARTHROPLASTY
- ELDERLY-PATIENTS