Only studies with bipolar hemiarthroplasty were analysed, excluding cases treated with unipolar prostheses or total hip replacement. In this work, we aimed to conduct a systematic review with meta-analysis to detect differences in outcome between cementless and cemented bipolar arthroplasty in femoral neck fractures in elderly patients as regards blood loss, mortality rate, operative time, hospital stay, dislocation rate and complications using the best available evidence. However, later studies showing promising results using cementless fixation have been reported. 5 Traditionally, cemented implantation is mostly preferred in elderly patients. Two implant categories are available, either a unipolar or a bipolar hemiarthroplasty. Hemiarthroplasty is a widespread surgical treatment of displaced femoral neck fractures in older people. The aims of treatment are pain relief, early mobilization and maintenance of the patient’s independence. The case for arthroplasty was strengthened by the use of bone cement that allows early mobilization of the fractured, elderly and morbid patients. 3 Treatment options include a wide variety of internal fixation methods, hemiarthroplasty or total hip replacement. 1, 2 They account for nearly 50% of hip fractures. DOI: 10.1302/2058-5257įractures of the femoral neck are common in the elderly and can significantly increase mortality, decrease mobility and increase the health cost. The existing evidence indicates that uncemented bipolar hemiarthroplasty offers shorter operative time, less blood loss, lower local complications and a similar rate of systemic complications and reoperations as compared to cemented implantation.Ĭite this article: EFORT Open Rev 2021 6:380-386. On the other hand, patients with cemented hemiarthroplasty suffered significantly less postoperative thigh pain than those with cementless implantation (p < 0.00001). Uncemented hemiarthroplasty was associated with significantly lower blood loss (p < 0.0001), shorter operative time (p < 0.0001), less infection (p = 0.03) and lower risk of heterotopic ossification (p = 0.007). Thirteen studies involving a total of 1561 bipolar hemiarthroplasties (770 cemented and 791 uncemented) were identified. We carried out a systematic review of the available literature to detect differences between cemented and cementless fixation of bipolar prostheses in treating femoral neck fractures in patients aged 60 years or older. Treatment options include a wide variety of internal fixation methods, unipolar or bipolar hemiarthroplasty or total hip replacement. The management of femoral neck fractures remains controversial.
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