title: Cementedversuscementless hemiarthroplasty for a displaced fracture of the femoral neck: a systematic review and meta-analysis of current generation hip stems.
abstract: OBJECTIVE
  Our aim was to prepare a systematic review and meta-analysis to compare the outcomes of cemented and cementless hemiarthroplasty of the hip, in elderly patients with a fracture of the femoral neck, to investigate the mortality, complications, length of stay in hospital, blood loss, operating time and functional results.
  
  
  METHODS
  A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on randomised controlled trials (RCTs), studying current generation designs of stem only. The synthesis of results was done of pooled data, with a fixed effects or random effects model, based on heterogeneity.
  
  
  RESULTS
  A total of five RCTs including 950 patients (950 hips) were included. Cementless stems were found to be associated with more complications compared with cemented stems (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.12 to 2.31, p = 0.01), especially implant-related complications (OR 3.15, 95% CI 1.55 to 6.41, p = 0.002). The operating time was shorter for cementless stems (weighted mean difference -9.96 mins, 95%CI -12.93 to -6.98, p < 0.001). The data on functional outcomes could not be pooled. There was no statistically significant difference for any other outcome between the two methods of fixation.
  
  
  CONCLUSIONS
  In hemiarthroplasty of the hip using current generation stems, cemented stems result in fewer implant-related complications and similar mortality compared with cementless stems. Cite this article:Bone Joint J2017;99-B:421-31.
authors.affiliation: Zuyderland Medical Center, H. Dunantstraat 5, NL-6419 PC Heerlen, The Netherlands.
authors.forename: H D
authors.initials: HD
authors.lastname: Veldman
authors.affiliation: Zuyderland Medical Center, H. Dunantstraat 5, NL-6419 PC Heerlen, The Netherlands.
authors.forename: I C
authors.initials: IC
authors.lastname: Heyligers
authors.affiliation: Zuyderland Medical Center, H. Dunantstraat 5, NL-6419 PC Heerlen, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Grimm
authors.affiliation: Zuyderland Medical Center, H. Dunantstraat 5, NL-6419 PC Heerlen, The Netherlands.
authors.forename: T A E J
authors.initials: TA
authors.lastname: Boymans
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D016063:Blood Loss, Surgical; D001843:Bone Cements; D002484:Cementation / Q000379:methods*; D005265:Femoral Neck Fractures / Q000601:surgery*; D062785:Hemiarthroplasty / Q000009:adverse effects / Q000379:methods*; D006622:Hip Prosthesis; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation / Q000706:statistics & numerical data
chemical_list: D001843:Bone Cements
keywords: Cemented hemiarthroplasty; Cementless hemiarthroplasty; Displaced femoral neck fractures; Fixation; Hip