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. 2022 Apr 22:29:101876.
doi: 10.1016/j.jcot.2022.101876. eCollection 2022 Jun.

Comparison of functional outcomes and complications of cemented vs uncemented total hip arthroplasty in the elderly neck of femur fracture patients: A systematic review and meta-analysis

Balgovind S Raja  1 , Aditya K S Gowda  1 , Sukhmin Singh  2 , Sajid Ansari  1 , Roop Bhushan Kalia  1 , Souvik Paul  1
Affiliations

Comparison of functional outcomes and complications of cemented vs uncemented total hip arthroplasty in the elderly neck of femur fracture patients: A systematic review and meta-analysis

Balgovind S Raja et al. J Clin Orthop Trauma. .

Abstract

Purpose: The neck of femur fractures in the elderly is a global concern. These fractures impair the quality of living and add to morbidity and mortality. A Multitude of treatment options for the same. This systematic review focuses on evaluating outcomes between cemented and uncemented total hip replacement in the elderly population with neck of femur fractures.

Material and methods: The search was conducted in databases PubMed, Embase, Scopus, open grey, and Cochrane following PRISMA guidelines. The studies fulfilling the inclusion criteria were included, scrutinized for data analysis, and also quality appraisal of all the included studies was conducted to be included in this article.

Results: A total of 7 studies were included (2 RCT, 5 retrospective studies) comprising 1171 THRs. Data analysis showed a higher HHS in cemented compared to uncemented(p < 0.001). The uncemented group had a significantly higher rate of revision, dislocation, and periprosthetic fracture compared to cemented group(p < 0.001). However, VAS score, loosening rates, and heterotopic ossification were similar in both statistically insignificant groups.

Conclusion: Choosing between cemented and uncemented techniques had been a controversy with lesser data due to higher morbidity and mortality. This systematic review provides information regarding functional outcomes and complications in both groups. The cemented group had better outcomes and lesser complications which should be preferred in elderly patients as the conclusion of this study. However, a larger RCT with better follow-up is still required.

Level of evidence: Level I, systematic review and meta-analysis.

Keywords: Cemented; Cementless; Neck of femur fracture; Total hip arthroplasty; Uncemented.

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Conflict of interest statement

All authors declare that they do not have any competing interest, concerning this research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Flow chart of selection process.
Fig. 2
Fig. 2
Forest plot of comparison: functional outcome (short term and long term).
Fig. 3
Fig. 3
Forest plot of comparison: for pain score.
Fig. 4
Fig. 4
Forest plot of comparison: various complication rates.
Fig. 5
Fig. 5
Funnel plots of included studies depicting HHS <5 years and radiological loosening.
See this image and copyright information in PMC

References

    1. Mao S., Chen B., Zhu Y., et al. Cemented versus uncemented total hip replacement for femoral neck fractures in elderly patients: a retrospective, multicentre study with a mean 5-year follow-up. J Orthop Surg Res. 2020;15(1):447. doi: 10.1186/s13018-020-01980-4. - DOI - PMC - PubMed
    1. Hadjimichael A.C. Hip fractures in the elderly without osteoporosis. J Frailty Sarcopenia Falls. 2018;3(1):8–12. doi: 10.22540/JFSF-03-008. - DOI - PMC - PubMed
    1. Cauley J.A. Osteoporosis: fracture epidemiology update 2016. Curr Opin Rheumatol. 2017;29(2):150–156. doi: 10.1097/BOR.0000000000000365. - DOI - PubMed
    1. Knobe M., Pape H.C. Anchorage strategies in geriatric hip fracture management. Innovative Surgical Sciences. 2016;1(2):73–78. doi: 10.1515/iss-2016-0034. - DOI - PMC - PubMed
    1. Miller B.J., Callaghan J.J., Cram P., Karam M., Marsh J.L., Noiseux N.O. Changing trends in the treatment of femoral neck fractures: a review of the american board of orthopaedic surgery database. J Bone Joint Surg Am. 2014;96(17):e149. doi: 10.2106/JBJS.M.01122. - DOI - PubMed

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