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 J 2017;99-B:421–31.
H. D. Veldman: Study idea, Study design, Data collection, Data analysis, Writing the paper.
B. Grimm: Study design, Data analysis, Writing the paper.
I. C. Heyligers: Study design, Writing the paper.
T. A. E. J. Boymans: Study idea, Study design, Data collection, Data analysis, Writing the paper.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This article was primary edited by E. Moulder and first proof edited by J. Scott.
- Received August 8, 2016.
- Accepted December 5, 2016.
- ©2017 The British Editorial Society of Bone & Joint Surgery