Cementedcementless hemiarthroplasty for a displaced fracture of the femoral neck: a systematic review and meta-analysis of current generation hip stems

H D Veldman, I C Heyligers, B Grimm, T A E J Boymans

Research output: Contribution to journalReview articlepeer-review

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 languageEnglish
Pages (from-to)421-431
Number of pages11
JournalThe Bone & Joint Journal
Volume99-B
Issue number4
DOIs
Publication statusPublished - 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

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