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. 2013 Mar 15;5(1):e8.
doi: 10.4081/or.2013.e8. Print 2013 Feb 22.

Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials

Ali Abdulkarim  1 , Prasad Ellanti, Nicola Motterlini, Tom Fahey, John M O'Byrne
Affiliations

Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials

Ali Abdulkarim et al. Orthop Rev (Pavia). .

Abstract

The optimal method of fixation for primary total hip replacements (THR), particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

Keywords: cemented; meta analysis.; total hip arthroplasty; uncemented.

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Conflict of interest statement

Conflict of interests: the authors declare no potential conflict of interests.

Figures

Figure 1
Figure 1
Flow chart of selection process.
Figure 2
Figure 2
Forest plot of comparison: overall revision.
Figure 3
Figure 3
Forest plot of comparison: long term follow-up (>5 years) for revision.
Figure 4
Figure 4
Funnel plot of comparison: overall revision.
Figure 5
Figure 5
Forest plot of comparison: short term follow-up (<5 years) for pain score.
Figure 6
Figure 6
Forest plot of comparison: long term follow-up (>5 years) for pain score.
Figure 7
Figure 7
Forest plot of comparison: overall pain score outcome.
Figure 8
Figure 8
Funnel plot of comparison: hhort term follow-up (<5 years) for pain dcore.
Figure 9
Figure 9
Pooled mean difference for pain score and functional outcome score measured by HHS.
Figure 10
Figure 10
Pooled Relative Risk for all outcomes.
See this image and copyright information in PMC

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