Cemented Versus Uncemented Hemiarthroplasty for Displaced Femoral Neck Fractures in the Elderly
DOI:
https://doi.org/10.5281/zenodo.22326865Keywords:
Hemiarthroplasty, Femoral neck fracture, Bone cements, Hip fractures, Bone cement implantation syndromeAbstract
Background: Displaced femoral neck fractures in the elderly are increasingly treated with hemiarthroplasty, but whether the
femoral stem should be cemented or uncemented remains debated because of concerns about bone cement implantation
syndrome versus periprosthetic fracture. Objective: To synthesise randomized trial, registry, and meta-analytic evidence comparing cemented and uncemented hemiarthroplasty. Methods: Narrative review of randomized trials, arthroplasty registries, meta-analyses, and guideline statements. Findings: The largest trial (1,125 patients) found cemented fixation reduced periprosthetic fracture (0.5% vs 2.1%) and improved quality of life at four months, with a non-significant mortality trend favouring cemented fixation (23.9% vs 27.8% at one year). Meta-analyses corroborate fewer periprosthetic complications and better function with cemented stems, at the cost of longer operative time and a small risk of bone cement implantation syndrome. Conclusions: Cemented hemiarthroplasty is now favoured by most guidelines and registries for elderly patients with displaced femoral neck fractures.
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