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Meta-Analysis
. 2008 Oct;466(10):2513-8.
doi: 10.1007/s11999-008-0368-3. Epub 2008 Jul 24.

Systematic review of cemented and uncemented hemiarthroplasty outcomes for femoral neck fractures

Jaimo Ahn  1 , Li-Xing Man, SangDo Park, Jeffrey F Sodl, John L Esterhai
Affiliations
Meta-Analysis

Systematic review of cemented and uncemented hemiarthroplasty outcomes for femoral neck fractures

Jaimo Ahn et al. Clin Orthop Relat Res. 2008 Oct.

Abstract

Although hemiarthroplasties are an important treatment for femoral neck fractures, the literature does not provide a clear approach for selecting the implant fixation method. Therefore, we performed a systematic search of the medical literature and identified 11 prospective and retrospective studies that compared results between cemented and uncemented femoral implant fixation methods. After independent blind data extraction, we compared variables between cemented and uncemented cohorts using two different meta-analysis models. Pooled data represented 1632 cemented and 981 uncemented hemiarthroplasties (average age of patients, 78.9 and 77.5 years, respectively). The average operating room times and blood loss volumes were 95 minutes and 467 mL, respectively, for the cemented and 80 minutes and 338 mL for the uncemented cohorts. Postoperative mortality rates, overall complications, and pain were similar between the two cohorts. Despite a few potential trends, we found few statistical differences between cemented and uncemented techniques based on reported outcome measurements. In addition, inspection of this literature underscored the lack of and need for consistent and standardized reporting of outcome variables regarding these procedures.

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Figures

Fig. 1
Fig. 1
The overall pooled relative risk using a RE model is shown. Relative risk (RR) is represented graphically with 95% confidence interval bars. The RR favoring the cemented cohort is left of the vertical bar and the uncemented cohort is on the right. Probability values for RE and FE models and number of studies included in pooled data are shown. Column Q shows the p value of the Cochrane’s Q test for heterogeneity.
Fig. 2A–F
Fig. 2A–F
Forest plots of the pooled RR for (A) perioperative mortality (less than 1 month), (B) intermediate followup (less than 3 months), (C) long-term followup (6 months and greater), (D) all complications, (E) revision, and (F) pain are shown. Each contributing manuscript (with summary effect at bottom) is shown with 95% confidence intervals for the RR (X axis) and percent weight contributing to the RE model.
See this image and copyright information in PMC

Comment in

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