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MINERVA ORTOPEDICA E TRAUMATOLOGICA
Rivista di Ortopedia e Traumatologia
Minerva Ortopedica e Traumatologica 2014 June;65(3):211-21
Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: an updated meta-analysis
Wang J. 1, Xu L. Y. 2, Ma J. X. 1, Xing D. 2, Yang Y. 1, Zhu S. W. 1, Ma B. Y. 1, Chen Y. 1, Feng R. 2, Jia H. B. 2, Yu J. T. 2, Ma X. L. 1, 2 ✉
1 Biomechanics Labs of the Orthopedics Institute, Tianjin Hospital, Tianjin, China;
2 Biomechanical Lab of the Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
AIM: Femoral neck fractures are one of the most common injuries in elderly people and are most commonly treated with hemiarthroplasty in the United States. Whether there is a difference in prognosis following cemented versus uncemented hemiarthroplasty for femoral neck fractures remains controversial. The purpose of this meta-analysis was to evaluate outcomes of cemented versus uncemented hemiarthroplasty for femoral neck fractures.
METHODS: Randomized controlled trials (RCT) were identified from computer databases. We extracted data on study characteristics, participant characteristics, and therapeutic interventions. We used the MINORS list to assess study quality and risk of bias. RevMan 5.1.1 software was used for data analysis.
RESULTS: Ten randomized controlled trials were included. The combined results of the meta-analysis showed that there were significantly more intra- and postoperative fractures in the uncemented hemiarthroplasty group than the cemented group. Operative times in the cemented group were significantly longer in the uncemented group. Cemented hemiarthroplasty was associated with significantly less residual pain. Furthermore, there were no significant differences in mortality between the two groups at 6 weeks, 6 months, one year and two years.
CONCLUSION: The available evidence suggests that, compared with uncemented hemiarthroplasty, cemented hemiarthroplasty for patients with displaced femoral neck fractures was not associated with a higher risk of intra- and postoperative fractures; cemented hemiarthroplasty also reduced the risk of residual pain. In addition, there were no statistically significant differences in mortality at different follow-up periods between the two groups.