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.
|Number of pages||11|
|Journal||The Bone & Joint Journal|
|Publication status||Published - Apr 2017|
- Arthroplasty, Replacement, Hip
- Blood Loss, Surgical
- Bone Cements
- Femoral Neck Fractures
- Hip Prosthesis
- Length of Stay
- Prosthesis Design
- Randomized Controlled Trials as Topic
- Journal Article
- BIPOLAR HEMIARTHROPLASTY
- UNCEMENTED HEMIARTHROPLASTY
- PROSPECTIVE RANDOMIZED-TRIAL