Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: A meta-analysis of randomized controlled trails

• Published in: Medicine (Baltimore) 2019-02, Vol.98 (8), p.e14634-e14634
• Main Authors: Lin, Feng Fei, Chen, Yi Fan, Chen, Bin, Lin, Chao Hui, Zheng, Ke
• Format: Article
• Language: English
• Subjects: Bone Cements - therapeutic use; Femoral Neck Fractures - surgery; Fractures, Malunited; Hemiarthroplasty - adverse effects; Hemiarthroplasty - methods; Humans; Outcome Assessment (Health Care); Postoperative Complications - etiology; Postoperative Complications - prevention & control; Randomized Controlled Trials as Topic; Systematic Review and Meta-Analysis
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000014634

The purpose of this meta-analysis was to compare the effectiveness and safety of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures. We searched PUBMED, EMBASE, Cochrane Library, and Google Scholar from their inception to February 2016. All RCTs comparing cemented with uncemented hemiarthroplasty for displaced femoral neck fractures were eligible. The participants who underwent primary hemiarthroplasty for unilateral femoral neck fracture were older than 55 and the mean age of more than 75 years old. For the trials before 2006 used old designed prostheses, so we excluded trails before 2006 which used old designed prostheses. Outcomes of interest include postoperative hip function, Harris hip score (HHS), mortality, reoperation rate, complications, operation time, intraoperative blood loss. Two reviewers independently evaluated the included studies and extracted data into RevMan. Quality Assessments were classified by agreement of 2 authors based on the Cochrane tool. Seven trials were eligible. Postoperative hip function at 12 months cemented hemiarthroplasty was better than that in uncemented hemiarthroplasty (OR = 0.52, 95% CI, 0.31-0.88; P = .01). Postoperative fractures rates in cemented hemiarthroplasty were lower than that in uncemented hemiarthroplasty (OR = 0.09, 95% CI, 0.02-0.38; P = .001). Also, the interoperative fracture rates in cemented hemiarthroplasty were lower than that in uncemented hemiarthroplasty (OR = 0.29, 95% CI, 0.13-0.68; P = .004). Shorter operation time was achieved in uncemented hemiarthroplasty than that in cemented hemiarthroplasty (WMD = 8.22 min, 95% CI, 5.57-10.86 min; P