Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: an updated meta-analysis.

OBJECTIVES: To compare the outcomes of cemented and uncemented hemiarthroplasty for treating displaced femoral neck fractures. METHOD: We searched the PubMed, Medline, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases from 1966 to Mar 2012. No language restriction was applied. Reference lists of all the selected articles were hand-searched for any additional trials. Trial quality was assessed using the modified Jadad Scale. Two authors independently extracted data from all eligible studies, including study design, participants, interventions, and outcomes (mortality, hospital stay, blood loss, operation time, residual pain, and complications). The data were using fixed-effects and random-effects models with mean differences and risk ratios for continuous and dichotomous variables, respectively. RESULTS: A total of 12 studies involving 1805 patients were identified in this analysis. Meta-analysis showed longer operation time (SMD, -0.43, 95 % CI -0.56, -0.30) in cemented versus uncemented hemiarthroplasty. There was no significant difference between the two treatment groups regarding mortality (OR, 1.08, 95 % CI 0.88, 1.34), hospital stay (SMD, -1.21, 95 % CI -2.24, -0.18), blood loss (SMD, -0.12, 95 % CI -0.33, 0.10), operation time (SMD, -0.43, 95 % CI -0.56, -0.30), residual pain (OR, 1.42, 95 % CI 0.99, 2.03), and complications (OR, 0.82, 95 % CI 0.63, 1.08). CONCLUSIONS: The available evidence suggested there was no significant difference between uncemented and cemented hemiarthroplasty in treating displaced femoral neck fractures.