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Contemporary cemented versus uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures: a meta-analysis of forty-two thousand forty-six hips

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A Correction to this article was published on 07 May 2019

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Abstract

Introduction

Controversy exists regarding the use of cement for hemiarthroplasty to treat displaced intracapsular hip fractures. The aim of this systematic review and meta-analysis was to compare the clinical outcomes between contemporary cemented and contemporary uncemented hemiarthroplasty for the treatment of displaced femoral neck fractures.

Methods

Literature searches of PubMed, Scopus, Web of Science, and Cochrane Central, up to May 2017, were performed. We included randomized controlled trials (RCTs) and observational studies comparing contemporary cemented with contemporary uncemented hemiarthroplasty. Data were pooled as mean difference (MD) or risk ratio (RR) with 95% confidence interval (CI) in a meta-analysis model. Studies with the Thompson and Austin Moore prostheses were excluded.

Results

A total of 29 studies (9 RCTs and 20 observational studies), with a total of 42,046 hips, were included. Meta-analysis showed that the cemented group was associated with fewer periprosthetic fractures (RR = 0.44, 95% CI [0.21, 0.91]), longer operative time (MD = 11.25 min, 95% CI [9.85, 12.66]), more intraoperative blood loss (MD = 68.72 ml, 95% CI [50.76, 86.69]), and higher heterotopic ossification (RR = 1.79, 95% CI [1.11, 2.88]) compared with the uncemented group. Meta-analysis showed no significant difference in terms of post-operative hip function, hip pain, reoperation rate, prosthetic dislocations, aseptic loosening, wound infection, and hospital stay.

Conclusions

This meta-analysis shows that contemporary cemented prostheses have less intra-operative and post-operative fractures, but longer operative time, more intra-operative blood loss, and heterotopic ossifications. Otherwise, there were no significant differences between both groups.

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Change history

  • 07 May 2019

    The author name “Muhammad Shawqi” was incorrectly presented as “Muhammad Shawq”.

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Authors and Affiliations

  1. Norfolk and Norwich University Hospitals, Norwich, England

    Mohamed A. Imam & Nish Chirodian

  2. Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Mohamed S. A. Shehata & Ahmed Elsehili

  3. Medical Research Group of Egypt, Cairo, Egypt

    Mohamed S. A. Shehata

  4. Faculty of Medicine Menoufia University, Menoufia, Egypt

    Mahmoud Morsi

  5. Oxford University Hospitals NHS Foundation Trust, Oxford, UK

    Alexander Martin

  6. Faculty of Medicine, Assuit University, Asyut, Egypt

    Muhammad Shawqi

  7. Balgrist University Hospital, University of Zurich, Zurich, Switzerland

    Florian Grubhofer & Lukas Ernstbrunner

  8. Ashford and St Peter’s NHS Trust, Ashford, Kent, UK

    Ali Narvani

  9. London, UK

    Alexander Martin

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  1. Mohamed A. Imam
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Correspondence to Alexander Martin.

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The original version of this article was revised: The author name “Muhammad Shawqi” was incorrectly presented as “Muhammad Shawq”.

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Imam, M.A., Shehata, M.S.A., Elsehili, A. et al. Contemporary cemented versus uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures: a meta-analysis of forty-two thousand forty-six hips. International Orthopaedics (SICOT) 43, 1715–1723 (2019). https://doi.org/10.1007/s00264-019-04325-x

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