Cemented versus uncemented hemiarthroplasty for displaced intracapsular fractures of the hip

Bone Joint J. 2023 Nov 1;105-B(11):1196-1200. doi: 10.1302/0301-620X.105B11.BJJ-2023-0534.R1.

Abstract

Aims: The aim of this study was to report the three-year follow-up for a series of 400 patients with a displaced intracapsular fracture of the hip, who were randomized to be treated with either a cemented polished tapered hemiarthroplasty or an uncemented hydroxyapatite-coated hemiarthroplasty.

Methods: The mean age of the patients was 85 years (58 to 102) and 273 (68%) were female. Follow-up was undertaken by a nurse who was blinded to the hemiarthroplasty that was used, at intervals for up to three years from surgery. The short-term follow-up of these patients at a mean of one year has previously been reported.

Results: A total of 210 patients (52.5%) died within three years of surgery. One patient was lost to follow-up. Recovery of mobility was initially significantly better in those treated with a cemented hemiarthroplasty, although by three years after surgery this difference became statistically insignificant. The mortality was significantly lower in those treated with a cemented hemiarthroplasty (p = 0.029). There was no significant difference in pain scores, or in the incidence of implant-related complications or revision surgery, between the two groups.

Conclusion: These results further support the use of a cemented hemiarthroplasty for the routine management of elderly patients with a displaced intracapsular fracture of the hip.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip* / methods
  • Bone Cements
  • Female
  • Femoral Neck Fractures* / surgery
  • Hemiarthroplasty* / methods
  • Hip Fractures* / complications
  • Hip Fractures* / surgery
  • Hip Prosthesis* / adverse effects
  • Humans
  • Male
  • Postoperative Complications / etiology
  • Treatment Outcome

Substances

  • Bone Cements